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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETi', WA 98201 <br />425-257-8810 - FAX425-257-8857-www.everettwa.org 3 "�"d7 <br />APPUCATIONS ARE ACCEPTED FROM 8 AM TO 4 PM L 070 3� �� <br />��<<( Cc�l���� <br />PROJECT ADDRESS <br />L-ct��ri e Sc�PP'���c�r �c�iy <br />Owner - Mail Addross <br />N Q - ____ _ <br />Tenanl MailAddress <br />f � C�. f� �= Iec�ric znc <br />Geclric2l Con�raclor Mail Address <br />j �P,� t� .� ;c c�Hy �F <br />Stale License Number <br />S�nc�I r -�m i �v �1'Ps�c��nr� <br />Proposed U c of 8uilding <br />Descriplion of Work to Bo Done: <br />. <br />�� i fl�r L � ► 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 3105 <br />Clty <br />City <br />aiy <br />��17 , u,�/� � b zc� <br />Slale2ip <br />SWIe21p <br />� (1 l�J/� �►ao �ll ' <br />Stale2ip <br />.1� 2�2G'�,c^c� <br />Conlracl Price oi Work <br />��,►-� r N, II <br />Conlacl Person (Plan Review) <br />i hereby certify lhat I have read and exmnined fhis application and know the same fo be true and <br />currect. All pruvisions ollaws and ordinances goverrung ifiis type oI work will be completed <br />�rhefhcr specified l+erein or not The �ronting o( a pemut does not resume fo give aufhonty fo <br />violafeorcancellhe provisionsolanyotherstateorlocallawreguPfingcons(nictionorthe <br />periemianco o/ consfn�ction. Thaf I am aidhonzed by fhe oivner o/ Ihis property to perlomr the <br />�rork /or �rhich application is made and 1 cornply �roifh fhe Sfate Contractors Law 18.27 RCVV and <br />29fi.200 WAC. <br />FEE <br />S�y. �i <br />Phone <br />Phonc <br />�; -Srrf <br />Phanc <br />