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w <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 C�DAR STREEI", EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�� 7 l � ��C`�CJ(� �' S l <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />Mail Address <br />Mail Addiess <br />City <br />City <br />L� <br />StatelZip <br />Slale/Zip <br />Ph�ne <br />Phone <br />(� 5 �r ..2_Cl/ 7,3 5� S� � vz.0 �/ ��.-f- 9>r.k, "s 335 s�y7 <br />Eleclrical Contraclor Mail Address Ciry Slate2ip Phone <br />�JS� �G 3'R' yE- G'2-� 6�l <br />State License Number <br />� - <br />1C'Cc �C"— <br />Proposed Use of Building <br />Contracl Price of Work <br />Conlacl Person (Plan Review) <br />Description ot Work lo Be Done: Lc �+ n /C C' c•) %i�X� �[' — <br />NOTE: WIRINC 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 />FEE <br />1 hereby certily fh��t I have read and examined this applicafion and know the same to be true and <br />cor�ect. All pmvisions o/laws and ordinances goveming this f}�pe o/wo�k will be cornpleted <br />tvhefherspetdied herein ornoL The granfinc� o/a perrnR Aoes not presume fo give au(honty fo <br />violafe or cancel fhe �rovisions o/ any other state or local law regu/atinc� constniction or the <br />perfonnance o/ consfrucfion. That 1 am authorized by fhe owner o� fhis property to perfomi fhe <br />work (or which app/icafion is madr. and 1 comply wifh the Stale Confracturs La�v 18.27 RCW and <br />296.200 WAC. <br />.� <br />� �C�- <br />� (�0 S <br />