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ELECTRICAL P�ERMIT 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 ACCEP7ED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> ,-'7� � COL L�U 1�-l�� 1It�' FLrL ���c.T �w� <br /> PROJECT ADDRESS <br /> �1� r`Or�� .�707 L'c���7v l�v� �+1�'� ���r=+ <br /> Owner Mai�pddress <br /> City State/ZiP Phone <br /> 1�21�0 '>N-v+�� A-s �i�aiJE <br /> Tenant Mail Address City Sfate/Zip Phone <br /> C-��,�jv�-rc= ��o /,��x :,77��o C—i.���� c�Ji� �I���� ��'.��3 ��.z�5G, <br /> Ele��trical Ccnlrer.tor Mail Address Ciry State/Z(p Phone <br /> L.�� l��l.� l � l �.:;,�i L �bC)C�cc- <br /> State License Number ConVact Price o(Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description af Wark to Be Done: ��� (' � � 1�6 1��1 <br /> NOTE: WIRING IN NON•DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> j SC, <br /> ;� — <br /> CITY OF EVERETT LOCAL SALE5 TAX CODE IS 3105 <br /> 1 hereby certily that 1 have read anC ex�mined this application and know fhe same to be true anC <br /> correct All provisions of/aws and ordinances c�oveming this type o(work wil!be completed <br /> whether specified herein or not. 7he granting o/a permd does nct presume to give authority to <br />� vidate or cancel fhe p�ovisions of any ofher statE or local law regulatir,g consWchon or the <br /> wo�k)cra vfu'ch app/c�a bo s made and I comptyedthihe State Cont acfosPLa v 18.Z RC W and <br /> 296.200 WAC. � <br /> � -, � i <br /> �� <br /> ��'i.�� lr�0`3-�0`� <br /> Signature D te <br /> � �%���— ��G/ <br /> I � <br />