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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAP, STREET, EVERETT, WA 98201 ;� �- �S -D % <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org G� �� 7 �5s <br />APPLICATIONS ARE ACCE�TED FROM 8 AM TO 4 PM <br />j J � -� <br />;�si'� t>�� � r_X� �/,�>l�;> l� r. �,��� �i <<,%<� if ?��� <br />PROJECT ADDRESS <br />�/% <br />Tenant <br /><,'E �r///��� <br />Eiectrical Conlrador <br />Mail Addrr.ss <br />/� �'LJ �i C� � � y/��� <br />hlail Address <br />_ � J �%/5 /�./��+/r) <br />Atail Address <br />�`� �'- ��� ' ' - <br />� �.. , .�, <br />Stale License Number <br />�;� � � . , <br />Proposed Use o1 �ulldin9 <br />Descriplion ol Work to Oc Donc: <br />NOTE: WIRING IN NON-DVVELLINGS IS R[�UIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />, <br />S_�i i��i«<°,cc�� C��a <br />CI�Y $�:31C/ZI�) <br />� / ��r <br />� N �/_rJ�_n/f�s / (', <br />City Stale/Zip <br />6 �__ . S,� ._�os " <br />Phone �� � <br />�L� 5%5 � 1 <br />Phone I <br />{ ,��� Ci �;c'e� Gc►t j���a �« ;; �, - <br />City Stale/Zip Phone=l+--�� <br />i <br />;��� _l�l� <br />Con�ract Price of Work <br />Cn/�7 <br />%/.�1�/� _ <br />Conlacl Person (Flan Revicw) <br />, . ' . . ��./ (� J�.� r /. <br />CITY OF EVERETT LUCAL SALES T.4X CODE IS 3105 <br />1 heiohy cnr6ly th��( I hav�r read nnd examined Ihis applicnfion and kno�v fhe sarne fo be t�ue and <br />con�;r.i. All piovisions el laus ;md o�dinnnces governing fhis fype o/ work n�dl be cornplefed <br />u�hefher specified hcrour or noL The g�nnting oI a pernuf Aoes nof vesume to give aufhority fo <br />violafe or cancel fhr. pruwsions o/ an}� olNer stafe or local I.��v mgu��finp consfrucfion o� fhe <br />peiforrnance of conshucfion- That 1 am autho�ized by Ihe o�tiaie� o/ thfs property fo perlorm fhe <br />�va�k Ior wh�ch applicafion is made and 1 cori�ply with the Sfate ConU+3clors Law 18.27 RCIN and <br />296.200 VVAC. <br />' ,� / / / <br />'�� � �/��j '� / - ��� � �/ <br />J'�. / % _ _ �� � �t <br />FEE <br />L C�"1C� � � I'>=i <br />