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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERV!CES <br />3200 CEDAR STREET, EVERETT, WA P�201 <br />425-257-8810 - FAX 425-257-8857 — www.�:verettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT &:.REDIT CARDS ARE NOT ACCEPTED <br />C� � 0 7 Bcv �r�c. y�nN 1= <br />PROJECT ADDRESS <br />ri3c./�2/ /-leDi��I,ES y�-5 33�1-t�(�f�f� <br />Owner Mail ACdress Cily State�Zip Phone <br />Tenant <br />M1tail AtlJress <br />City <br />Stale/Zip <br />Phono <br />_/1,{ C(� I N i�'� G LG_C. 1/ZlL L l� / N l. <br />EleclriCal� Mail Address Cily Stdte/Zip Phono <br />M C. C�//� �=L 00 3 N J <br />�tate License Number <br />S Fr� <br />Proposed Use of Building <br />ConUac! P���e of Work <br />Contact Person (Plan Review) <br />Description of Work to Be Done: /t-� �- W ��y �/d -.Z Od �' N�lP <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 3105 <br />I he�eby certily Iha( I have read ard examired fhis applicafion and know the same lo be true and <br />�o��oc�. nu ��ows�o�,s o� raws and ordinances gm�enung this type ol work wil be cornplefed <br />�shefher specilied herr.in or not The c�rantiny ol a pennd does not resume f� giva authonty to <br />violate or cancel fhe piovisions ol any ofher state or local Imv reguPting cone6ucfi�n ur the <br />peAormance o/consfn�c6on. Thaf 1 arn authorized by the awner o/Ihis propn�'y fo pedonn the <br />�vo�k Ior �vhich applicafion is made and I cornply with the Stafe Contracfors Ldrv If�.27 RCW and <br />290200 WAC. <br />'J/— li5 <br />FEE <br />$. } o 0 <br />��5�- ��� <br />