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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS AR[' ACCEPTED FROM 8 AM TO 4 PM <br />.��D� �l�,ei4-� f� l//� <br />PROJECT ADDRESS <br />4zs�3� <br />f�.4 L i�FiJ,b.��.s.��-/ � I�- y�o�'��a�e ��D�.e.C� �i6Z� �-�299 <br />Owner Mail Address Cily Slate/Zip Phone <br />Tenant <br />�u.(/J4c'� <br />Eleclrical Conlreclor <br />� �'�/N <br />Slate License Number <br />S F r-{ <br />Proposed Use of Building <br />Mail Address <br />Mail Address <br />Cily <br />City <br />State2ip <br />State2ip <br />'� j� � c-O <br />Cont�ce of Work <br />G�2�1 1l,�"CS orl <br />Conlact Person (Plan Review) <br />4z5 - �+5 — 42109 <br />Desci iption of Work to Be Done: I��iMO O� �1� iS"i� ��7 S� I"� <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 />1 hereby certily thaf 1 have �ead and examineA this application and know fhe same to be irue and <br />correcL A/l provisions o(laws and ordinances governing this type ol work wi/l be completed <br />whefher spe^�fied herein or noL The granting of a pernut does not� resume to give authonty to <br />viola�e or r,ancel the provisions ol any other stafe or local law regulating construcfion or the <br />perlorma�,ce o/ constn�cbon. TAat ! am authonzed by the owner oI this property to per;orm the <br />work lor ;vhich appliqationy'S made and I comply with the Sfate Contractors Law 18.27 RCW and <br />Z96. ZOO WAC. A/./ �\ <br />/ <br />Y�� <br />Phone <br />Phone <br />FEE <br />� ' <br />