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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES �.-3—oy <br />3200 CEDAR STREET, EVERETT, WA 98201 L O�O �4 /� <br />425-257-8810 - FAX 425-257-8857 - www.everetlwa.org <br />APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />��OS S'F �vercff'/�fa/� GJ <br />PROJECT ADDRESS <br />Owner <br />Mail Address <br />City <br />State2ip Phone <br />�2V'i"�w` i.�ireLe�'� .335� Ilv�s� �tve,S� ���eVv-t�t.�k i5ia�78' 1{2f-(,o; Z <br />Tenant MailAddress City StatelZip Phone <br />M�tC�NS�'►'U/ E�t-+�n.lc� pFJ z�f1�b� ;i�..�il�- w� % P 2ob-�bL-3 <br />Eledrical Conlraclor Mail Address Ciry State2lp Phone <br />C,i�-..L�� � I O Z ��.17 <br />State License Number <br />c,� NM N.�2.(-i'q't-- <br />Proposed Use of Building <br />3, o00 <br />Contract Price of Work <br />�� W. ! C�7'J't+'1 bk U;�.� <br />Contact Person (Plan Review) <br />Description of Work lo Be Do�e: �%<c-�'+'1 C� �'— r�i �� «�'^^�"'� v r Z %� �"' r <br />W ,1�.,, � � ) 3 . s � � ��. �- �,,.,-p �., �1 c � ) �[ f� � �.<.,.t P �:�-� _ <br />�— <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED ?O <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certi/y that 1 have read and examined this applicatron and know the same to be true and <br />correct. All provisions of laws and ordinances goveminq this type of work will be complefed <br />whefher speci�ed herein or not. The granting o(a permit does not presume to give authority to <br />violate or cance/ the provisions oI any other state orlocal law regulating conshuction or the <br />peAormance of construction. That 1 am authorized by the owner of this propeny to peAorm the <br />work /or which applicafion is made and 1 comply with the State Contractors L� w 18.27 RCW and <br />296.200 WAC. <br />0 <br />FEE <br />�/U ^7. vv <br />Fo�aB-�S <br />