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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES �_ y�b(o <br />3200 CEDAR STREET, EVERETT, WA 98201 7 <br />425-257-8810 - FAX 425-257-8857 — wv�nv.everettwa.org CQ �,,0�7� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />`�D � � n �{ 1!!�� �V n\1� <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />Mail Address <br />� OVl��nc� <br />Mail Address <br />�p //' <br />ct,�hn,�i� V7 ( On5'1� ;,t Z�� C <br />Eleclrical Contraclor Mail Addms� <br />Slato License Number <br />VF��Ce �P<�L'L <br />Proposed Use ol �uilding <br />�escriplion ot Work to B� Dono: / J ( <br />�f l _1�ri� S�1G>. _- <br />NOTE: WIRING IN NON-DWELLINGS la REQUIRED TO <br />DE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TN( CODE 15 3105 <br />Cily <br />City <br />Cily <br />Slate/Zip <br />SWIe/Zip <br />Stale2ip <br />f'hone <br />� Phone <br />�� �J�uLC <br />Contracl Price of Work <br />�OC' 1`i1�QUfn <br />Conlact Person (Plan Rwiew) <br />I have read and examined fhis applica(ion and know the same fo be frue and <br />ns ollaws and ordinances govemmg fhis type ol �vork �rill be comple;ed <br />erein or not The granting of a per,�ut does nol resume to giee authonty to <br />r provisions ol any ofher sfate or local law reguP(ing consWchon or th� <br />struction. Thaf I am authonzed by fho owner o/ this property io perfomi fhe <br />cafion !s mado and I comply wifh the Slafe Contractors Law 18.27 RCIN anA <br />� <br />; .-���� _ c�v � <br />FEE <br />,� �N�1Y� <br />