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ELECTRICAL PERMIT APPL�CATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-5810 - FAX 425-257-8857 — v✓ww.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM _� <br />�`7(:' � ���'r�A�Y_c� l� �,���\�� <br />PROJECT ADDRESS <br />� <br />Tenant <br />Mail Address <br />hlail Address <br />City <br />C=L�%O/`��y� <br />Ly�s� <br />� ��-��: <br />(aA 5�5�0 "> <br />State!Zip Phone <br />Stale/Zip <br />19iL.Lte7 <br />._ la��� <br />�n� �� I�, �-�, o;�S �30 a A S-I I a n nnr, ��� l� 9��ID �(cL��c -C��� 3 <br />Elec�riCal ConlraClor Mail Address City StatelZip Phone <br />��rn�Sc�<�--�3I K l <br />Stale License Number <br />Proposed Use of Buildin� <br />Descriplion of Work to Br. Done: <br />� � �' ��2 ilrr, �� Sncti����� c � <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 />� �S"p0 � u a <br />� <br />Contract Price of Work <br />Conlacl Person (Plan Reviea) <br />1 hei�by ce�iily fhat I have read and examined this application and hno�v fhe same to be Vue and <br />correcf. All provisions ollaws and ordinances governing fhis type o`u�ork wilf be cornpleted <br />�vhether speci6ed herein or not. 1'he grantinc� o/a perrnd daes not resume to give authorily to <br />violafe or cancel the provisions olany oGier state or focal la�v rec�uPtiny consUuc6on or tlie <br />pe�forrnance olconst�uc6on. That I am aufhorized by fhe o�vner o/ this properi}� to perfonr (he <br />wo�k Ior �vhich applicafion is made and ! wmpty nafh the Stafe Confractors La�v 18.27 RCW and <br />29G.200 WAC. / <br />�- /( ' / <br />� �;��' .�%��� _1- ��� <br />FEE <br />�C�c}(� 1 - C%j� <br />