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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br /> S t <br /> PROJECT ADDRESS <br /> ,;led <br /> �1 'rrr 4 . ;3_t � 371S- L Lz ,4 LE- bye r tj ltJa, q;zr 3&s- ya, <br /> Owner Mail Address City State/Zip Phone <br /> 3,155 c / 7ci / 3 0 Y X5 07` ST Ek)- L' enr7T kA. 9TJ03 <br /> Tenant Mail Address City State/Zip Phonc <br /> p«�r � It �l�tltfe;rQL I' � � /6e�onlrn eRrr� arup. s�r,� ll? P,:)ic,� 4 ��. . <br /> Electrical Contractor Mall Address City State2i�Js 37'1 77paF'hone <br /> PA(I Fr<<' 7 41 A ,vet. <br /> Slate License Number Contract Price of Work <br /> fRif)Y S/1L)CS - <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: �— <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO F[E <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify that I have read and examined this application arid know the same to be true and <br /> correct. All provisions of laws arid ordinances governing this type of work will be completed <br /> whether specified herein or not. The granting of a permit does not presume to give authority to <br /> violate or cancel the provisions of any other state or local law regulating construction or the <br /> Pork forawhich applictation Is made and I comply w with tthe Stale ConfracforspLaw 18 27 RCrW and <br /> 296,ko WAC. <br /> Signature Date <br /> �� o7c u3 <br />