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�LECTRICAL PERMIT APPLICATI�N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STR[ET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — wvdv+.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM 70 4 PM <br />�. � (� � <br />s�.� ����,-��f �?�: 1��.�v E <br />PROJECT ADDRESS � <br />/-1 I � � <br />Owner <br />� � � <br />Tenanl <br />l <br />' ? � - ��� �r <br />Electrical Conlrector <br />`��-. (G' S�t,, <br />Mail Address <br />zrc 5w <br />Mail Address <br />� %,��(�i C <br />Mail Address <br />CL�Lt <br />��tt«/� <br />Cily <br />�l/ri�- �� ��/!?u �iu <br />Cily <br />c'V�YU� �` I `!�� <br />Gty <br />S I C-V✓T' ��' OG 6 Pl � <br />State License Number <br />�e %t r� _ <br />Proposed Use of Eiuilding <br />F_vv. �l? �ii4, <br />SlatelZip Phone <br />��� E �v� <br />Slale2ip <br />�� Phone <br />,,, ✓✓A `lS�z6 <br />Slate2ip <br />� G y <br />l Sd� (i� �- <br />Conlract Price of Work <br />3Gc7 e�Tl-�3 <br />Phone <br />Contacl Person (Plan Review) <br />Description at Work to Be Done: �G�� 2 � 1� 1 �r��v� -�"� S�« t� l" �''v _�'o�i �� �7 •4 ✓�_ <br />� <br />NOTE: WIRING IN NON-DWELLINGS IS R[QUIRED TO <br />BE IN RACEWAYS, MC OR AC CABL[. <br />CITY OF EVER_TT LOCAL SALES TA.K CODE IS 3105 <br />1 hereby cerfily Ihat 1 have read and examined this applic <br />correcL All provisions of laws and ordinances govemmg <br />whefher specified herein or not The grantin� o( a pemut <br />violale or cancel the provisions ol any other state or loca <br />alion and know fhe same to be true and <br />fhis type o( work u�ill be completed <br />does not resume to give aulhonty fo <br />I law reguPling construction or the <br />� ov.�ner o/ this property to pedorm fhe <br />Sfate Contrac(ors La�v 18.27 RCW and <br />FEE <br />���c9-lz� <br />