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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERf1AIT SERVICES c� <br />3200 CEDAR STREET, EVERETf, WA 98201 S� a b`�� <br />425-257-8810 - FAX425-257-8857-www.everettwa.org C"�ODS-�36 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�g �- � �-c� ��'�v+r'e � l� E' • � uC� Ye� � 6-� � oj 8d,a I <br />PROJECT ADDRESS <br />Owner <br />s <br />Tenanl <br />� I IY U <br />A7ail Address <br />Mail Address <br />Cir/ <br />Cily <br />E��alr <br />e'frnarc %30P• i,)A• 9; <br />Scate/Zip Phone <br />�Ia.S� �-y <br />S1ale/Zip . _ Phone <br />_p'�'�� C�7r�w� u.N i c�4T i�r4 � f 3�3� .�.��7'`Sf .N � A�, L. r,�9 .�j$o�.z3 <br />Eleclricai Contraclor Mail Address � Cily , State/Zip . Phone <br />/ ;. _ ,...%,;'�� � � l� <br />{ZoThC '���99/L2. �/�S� o0 <br />S�alo License Number � Coniracl Price ot Work <br />�i ee �X�83+�I5 i D�'{ . <br />Proposed Use of Building <br />Contacl Person (Plan Review) <br />DescnplionofWorktoOeDone: L�l-� l2r'7��I��S� ��M��OR� /�%�� <br />�c��'�(°��h4@ C/���1�— --- <br />IJOI c: WIRIMG IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 heroby ceriity fhaf I have read and exemined this application and knorv fhe same fo bo truo and <br />eonncL All pruvisions o(laws and orAinances goveminy fhis typs of work �vill be complefed <br />�rhefher specificd herein or not. The granting o( a pernut does nol �msumo fo give aufhonty to <br />violale er cancel tho provisions ol any ofher stafo or loca! Iaw re�ulafing wnstruction or the <br />pedomrance o/ construction. That 1 am autho�ized 6y fhe otsner o( fhis property lo pedonn (he <br />nrork lor �vhich applicafion is rnade and 1 coniply nith the State Confractors Law 78.27 RCW and <br />29G.200 INAC. <br />FEE <br />GI UU� 13� <br />