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ELECTRICAL PERMIT APPLICATIaI� <br />CI'TY 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 />�7 7 ,�- <br />7 %��-� i':1;�c��<C,;:c."ci✓ ��vAti7 i� ��/v� <br />PROJECT ADDRESS � <br />S - 2-�-° 8 <br />Co �o s�l u5 <br />,- �� � = <br />')- C�>��t�C_ l'L���-//yz1 i)2:.' S�`= ,�'�zc�.�vc: 1.::) �— � <br />_�_��c . v�o 9 i-;� <br />Owner A1ail Address Ciry StatelZip Phone <br />� <br />Tenanl <br />� j'%�'o � C��i�i�. �L'i7�� (�ii�y i��� �; jv� � <br />Mail Address Cily Slale/Zip <br />Phone <br />�y � S- <br />o n � . j -> / .- i' �-t � ' 7 . <br />tiSv% �71,� Scl:v'tic., �1,1.1Z [-,ci�( -c1t� l:1 y 1L11 t('xc21� �l-t-�=1 �.r�5%6� <br />EleclriCal :oNractor Mail AdJress City State2ip Phone <br />7-, <br />/.i:� �/i � %%r�;J(, <br />Stale License Number� <br />-%fjiv:l'iil�l. <br />Proposed Use of Building <br />_�i _� <br />Contracl Price of Wor4: <br />Contact Person (Plan Review) <br />Description of Work lo Be Done: ���`, i 1) 2 c ��P, �-` C�l fi'iiv'�� 't-L I i� 1�J� /�15 �''L'7 `� <br />��� � <br />/�,i.� �=f+-;il �/� i�_TI_�iJ,�L�i', -i��vi7t <br />NOTE: WIRIP:G IN NOv-DWELLINGS IS REQUIRED TO <br />BE IN R/,CEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby r.ertily Ihat I have read and exarnined fhis applicafion and know fhe same to be true and <br />correcL All provisons olla�vs ar.d ordinances govemmy fhis (ype ol wo�k tvill be completed <br />wf:ether spea6ed herein or noL The granting o(a pernut does nof presume fo give authonty to <br />eio/ate or cancel the ,.rcvisions o(any o(her stafe or!ocal la�v regulaling con..truc(�on or the <br />peAormance o! construclion. That 1 am aufhorized by fhe o�rner o� ihis propeRy to per(orm the <br />�vork lor n�hich application is made and I comply �:ith the Slafe Contractors Law 18.27 RCIN �n.i <br />29G.200 WAC. <br />FEE <br />t�(�5-1 �l s <br />