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� <br />ELECTRICAL PERMIT lAP�LICAT'ION <br />CITY {JF EVERETT PERMIT SER.VICES <br />3200 CEDAR STREET, EVERETT, WA 9f;201 <br />425-257-8810 - FAX 425-257-8II57 — www.e�derettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />-� . <br />�(: c=l��-�: ���� �-�� <br />PROJECT ADDRESS � <br />/�—f�i���' L.� �_ (;i.���._.�!.i L._;.•.j— yr�-c� .. <br />Owner A1ai1 Address City State2ip phnne <br />���i lls.�.i� r �Tbf 4� `�L� % f�,��z�-.; ��.; r,,%�i-�, '. ����r �� l <br />Tenant Mail Address City `State2lp Phone <br />�J'�"�� f��S,i� <br />Electrical Contractor <br />b.�l�l1: 1 /�./i? i <br />h;�'1 J /1� �' 9i = ,;j <br />State License Number <br />n. <br />N i�\ � L <br />Proposed Use of Building <br />Mail Address <br />Descrip'ion of Wcrk to 3e Done: I.�� � �Z 1 L L � rJ = <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN R,4CEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />.�7f1.�'�7 irr�t; t..--�.J' .�r,a 'rlf- - -J.L <br />Ity Stale/Zip Phonc <br />.3� �: • - . <br />Conlract Price of Work <br />i 1='�,�%1-_ <br />Contacl Person (Plan Review) <br />� I L S/,=� J i G,.� <br />FEE <br />I hereby ceriify that I have read and examined this appG,:ation and know the same to be true and <br />correct. All provisions ollaws and ordir,ances governing th�s fype o(work will be compfeted <br />whether specdied he. ein or no!. The granting of a permd does not presun�e fo give authonty to <br />violate or cancel fhe provisions of any other state or local law reUu/ating cons(ruction or the <br />peAormance o( consfrucGon. That I am authorized by!.`,e uh;-er of this propeRy to peAorm the <br />work (or which application is made and I comp(y with fhe S(ate Confractors Law 18.27.RCW and <br />296.200 WAC. <br />i <br />�� I � / 1 1 /� i <br />Si ture � Date � <br />�a5o3-a9� <br />