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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMiT SERVICES � �.,0 5 <br />3200 CEDAR STREET, EVERETT, WA 96201 4` <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org �� � t� ..v �� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />i `� -'�i'''i i'�;i�. <br />PROJECT ADDRESS <br />,. � � , <br />('Lc. i rSrC�rV c/"� �_I���Ir � �- - <br />Ownef Meil Adtlress <br />Tenant <br />t,4ail Atldress <br />�: �� ; �� �� �- 4�c � L r �.,���� ��� �H � <br />�;;y Slate2ip Phone <br />City <br />Slale/Zip Phone <br />1 � � 7 <br />i� �- r��c�rl'/� il�C ',i,-7 �3` ��L �� �]i�T, w'f; ;S;i��i.� Z�ti j�(c �;<�<� <br />ElecincalConlrador MailAdtlress Ciry State¢m Phone <br />1,? L� �. L. I, F;- `:i � y lV t5 _ <br />State License Number <br />�� .. /�- i �] L (.,i =�� , c E' <br />Proposed Use of Building <br />Descnplion of Work to Be Done: � � �''� � <br />.'L.l'-t� I i=��-�J <br />���'C.G (-c <br />Conlract Pnce of Work <br />Contad Person (Plan Revie�v) <br />•'� �����.�il ��! _i-� (_ � l r-�- l T�i� 1 <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX C6DL IS 3105 <br />I heroby certify fhal l have read and eMamined fhis applicafion and know the same to be Irue and <br />conecf. All provisions ot laws and ordinnnces govemrng this type oI work will be compleled <br />whelher specified herein or noL The granfing oI a pc�rmd dces not presume fo give authonty to <br />violele or cancel the provisions ol any Wher sfate or local 1»w regulating consWction or th= <br />peAom;ance o( nstruchoa That l,am a'ufhonzed by fhe owner o/lhis property fo per�ortn the <br />296200 IyAC e�Plicafion is madB'and 1 comply with fhe Stete Conlr�ctors Law 1827 RCW and <br />� _ • � � _� ��. <br />� i �. <br />FEE <br />�0`iU�1-G�� <br />