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ELECTRICAL PtR"�IT APRLICATION <br />CITY OF EVERETT PERMIT SCRVICES <br />3200 CEDAR STREET, EVERE7T, WA 98201 <br />425-257•8810 - FAX425-257-8857—www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CAROS ARE NOT ACCEPTED <br />�� 5 0�- � F���tn �. r rvC� t�t rv �T- � <br />PROJECT ADDRESS <br />�� �� <br />S I-� �1`1- v rv m i i C t i� � C. (� Sa rn�c a s�. hvv�c. � i'�-�j � I�1 �� <br />Owner MailAddress Ciry Siale2ip F�one <br />Tenant <br />f/i��'1 W..{JJ � <br />Mail Atltlress <br />�G (�'�yl <br />ElectncalContractor MailAddress <br />`1�1012T1-t-C-S ,D�PS2 C,� <br />State License Number <br />�rn� <br />Praposed Use of Bwlding <br />Descnption of Work to Be Done: a <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 31�5 <br />City <br />+ H � G(�j <br />c�ry <br />StateRip Pnone <br />lbll-19� S ) N� �7� <br />— 5��1-Y� <br />f'tY7 (�?�e� 'pn. ujY-i `� fa�P��e�' <br />�' t 4- (� � � 0't� <br />Contract Pnce of Wor/k <br />J I I1n �'LGt � S �-YU <br />Contact Person (Plan Review) <br />I hereDy ceRily that I have iead and examined lhis application and know tho same to be true and <br />correct All prowsions o/laws and ordinances govem�ng this type o/work will be completed <br />whelher specified herein or noL The granting ol a permd does notp resume to give authonty (o <br />violate or cancel tho provisiors olany oMe� state or local law regula�ing consfruction or the <br />peAormancei o/ construchon. That 1 am authorized 5y the owner o/ fhis property to perform fhe <br />work �or whicb apphcahon is matle and I comply �vrth (he State Contracfors La�v 7927 RCW and <br />296100 WAC. <br />�-/3�Ulo <br />FEE <br />--��— — <br />; , , -, � <br />�L-�'� <br />