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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 8 AM TO 4 PM <br />=�3C%� �Ic�55�� � � S'� <br />PROJECT ADDRESS <br />. �Cl � Lrt' � <br />Owner Mail Address City State/Zip Phone <br />L�r, 51i�'�*�� c, �� �: ����� =Y ., — �-/7 5 <br />�, G�� / y/' 7y�� <br />�Lt•'1 �LiN.::�:.<`�""lt'r+'i� -�.�(.�.<:l �?CiSJ�(-' _�� �li�vV'r�'f` L�.Ct ��/ IS�'�C.i <br />Tenant J Mail Address City State/Zip Phone <br />��Ca� (1 vtr; � (% `rv t �, //>CJ j !. �'V:�, �i is�_ '� � 2 �. ii ''✓-r' .�-,.w �+rc3L / li z'(.�% 1 � � - : �� �% <br />� ! <br />EleCtrical Contractor �% Mail Address City State/Zip Phone <br />��;iCC �� <br />License Number <br />,���.t J C � � � <br />Proposed Use of Building <br />�i <br />� IC'', C'l'�� <br />Contract Price of Work <br />�c�, � t�7 I ��•1� > c.� <br />Contact Person (Plan Review) <br />Description of Work to Be Done: ��1�,�-�i / ( � rc,'� l ( i� � (��Yc� �C��(; -��� . �� �4 /c:� /l �� �y%c: �r-. � <br />� � 6� �a:�-6c �l `� ) ����� �e�'S ��o� 1/0 �u� e ��� ��L s <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />! hereby certify that 1 have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances governrn� this type of work will be complefed <br />whether specified herein or not. The granting of a perm�t does nof presume to give authority to <br />violafe or cance/ the provisions of any other state or local law regulating construction or the <br />performance of construction. That I am aufhorized by the owner of this property to perform the <br />work for which application is made and I comply wifh the Stafe Confractors Law 98.27 RCW and <br />296.200 WAC. n. <br />• <br />Signature <br />- �-�-z�l-��. <br />FEE <br />C� [�.O �-[Z�'r <br />