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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVIGES <br />3200 CEDAR STREET, EVERETi', WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />0 �/.� �c�/'U4G� Lti4�/ <br />PROJECT ADDRESS <br />Owner <br />Tenanl <br />� �xcV�(_ �4ii <br />� Mall Addr� <br />M11ail Address <br />City <br />State/Zip <br />Slale/7_ip <br />s �u �►� <br />C 11 D S�-lJ 7� <br />Phone <br />Phono <br />l�s o� � �/l 7.� sr S£: /_—��e+�c fl c� � "'v�oS' cits �ss's� <br />GlectricalContracto� M;IIAddress Cily Stale/Zip Phone <br />._(.Z:S T S� x�� dzz, �32 <br />Slalo I.iconso Number <br />� 7Y, �c� i,� <br />Proposed Use of Building <br />/� c>�� <br />CoMract Price of Work <br />Conlacl Person (Plan Review) <br />Descripl(onofWorklo[3eDono: J'e-4�r<-c /,�<<<(c(� �c/e%4 i� <_ e�,! 4. <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN R,4CEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES 7AX CODE IS 3105 <br />1 hereby certily fhat 1 havo read and axandned this applicetion ond know fhe same to be true ond <br />correct. �II provisions o/laws and crxlinances govemmg Uiis typo o/work wi/1 Ge comple(ed <br />rvhether specilred he�rin or noL The granting o/ a pemut dons not presumo to �ive authonty fo <br />viola(u or cancel the provisions o/any o(her state er /ocal law regulating consWcfion or fhe <br />pedomiance ol construcfion. Thaf ! arn aufhorir.ed b}� fhe ou�ner o( this property to perfonn !he <br />work lor �vliich application is mado and 1 comply wifh Mie Sfafe Contrac(ors La�v 10.27 hCl1`and <br />296.200 WAC. <br />_e. .�_ - -'/-.Se_, _ .�%%4.y .�( 1Gl <br />FEE <br />'. � I l�S - O ZZ- <br />