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ELECTRICAL PE�MIT APPLICATIQ�1 <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 ACCEPTED FROM 8 AM TO 4 PM <br />�; GLl �vG�G,nc%�=,v l�,�� Y <br />PROJECT ADDRESS <br />�Z U /!�f (3 � r"t <br />Owner <br />Ci <br />,is �.%��c <br />A9ail Address <br />Clly <br />State2ip <br />S -D � <br />� 070.5 <br />Plione <br />�l)G�.�!�l2[� �IU�LL-S <br />Tenant A1ail Address City State2ip Phone <br />�� ��Di)�n/6 �l�ci�2ic. l�y �y���, %�L ;I�J ,CY�vti��v��� lvfi �`�"�S� <br />Eleclrical Contractor Mail Address Cily Slate/Zip i,Z1 _J,phpn� 7 <br />v Ud' <br />I�l?�nD���O(.�h"7 <br />Stale License Number <br />�i'%✓i(��i �%t C IG7L <br />Proposed Use of Buildinr� <br />Description of Work to I3e Done: <br />r'7 r .�Ls�l�, <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRFD TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />or <br />3�'7�ti •oZ� <br />Conlract Prico of Work <br />Contact Person (Plan Review) <br />1 have read and exarnined this application and know fhe same fo be t�ue and <br />ns o(laws and ordinances goveming fhis type olw�rk wili be complefed <br />=rein or noL The �ranting oI a permd does not presume to give authonty fo <br />� provisions olany other stafe orlocal law regulefing construcfion or fhe <br />>frucfion. fhaf I am aufho�ized by fhe o�vner of fhis property fu peAomi fhe <br />cafionjs�made and I compty tvith fhe Stafe Confractors La�v 18.27 RCW and <br />U ��' � % • U 1 <br />FEE <br />� /� <br />. `�'il�� .J <br />