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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVlCES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — Nr,vw.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />, �, ; �,—�� � r�� L J��;- _- <br />PROJECT ADDRESS <br />��?GC- c�/rN%J//yG- I-�•L!% (,- �''.. '1 <br />/ �-,'')��rCi'I -5��='P f�,7Y'� �- i i= !•��n�w I <br />( � <br />. : � %i1�iG� �d l ���'� /_.�.�� �/�Jx/,�/'.Rc,� �; �:r� � - <br />Ownef M1.1ail Address City Slate/Zip Phone <br />Tenan� <br />Mail Address <br />Ciry <br />State/Zip <br />Phone <br />�' -o _ ! r J � _ � _ <br />r� — >> 7—J cG — ' � � _ <br />/_ :z'= �_."tr, � �-�r "iC .O..�o� �� E�-�'CiN.-�r�,.J �-� .J j(L--�.3�E-i:iS <br />Eleclrical Contractor A1ail Address Cily SlatelZip Phone <br />��_iT=1_c /3;_,�`j <br />Slate License Number <br />/'i�.'�: � : ?-c� <br />Proposed Use of Building <br />� JJU. c�x <br />Contract Price o( Work <br />Conlact Person (Plan Review) <br />Description of Work lo Be Done:/.�,s>:�ac. %!; �!�i�a<. �ur_/a � �/.'� n+ ���/ � YC� �'��r� �T�� T'� — <br />— . <br />��r:c.n-/ Sc-�"Vici� /%�'a,H 7J�r= /.�c� �G�JIi �/�./�si��i. �LPccJ �'i?7-.�J.Va�=/ <br />NOTF: WIRING IN NON-DWELLINCS IS REQUIRED TO <br />BE IN RACEWAYS. MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />FEE <br />1 liere6y certily thaf I have read and examined Ihis application and kno�v �he same (o be true and G�U� � I�� <br />cerreG. All provisions olla�vs and ordinance� prv -mu�g th�s type el tvork will be completeo <br />�vAefher spea6ed herein or noL The grantin,q „r a p�mut does ne( presume fo give authonty tu <br />violate or cancel the pruvisions o( any other sfate or local la�v regulafing construchon or flte <br />perlo�mance o/consfn�cl�on. That 1 am authorized by the ownerollhis propert, to perform the <br />��,ork (or which application i, made and 1 comply wilh fhe Sta(e Contractors La�v 18.27 RCW and <br />: P6 200 WAG. <br />!ii / <br />jf��z-'�.�^;,c.� ��z}-/��' <br />� SignoWre� " .�to <br />