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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 ARE ACCEPTED FROM 8 AM TO 4 PM <br />��D /�' ��r�� <br />� �/Z� �� ��, -.� }�_ <br />PROJECT ADDRESS <br />s,; <br />Owner <br />Tenanl <br />� Oti��s�or✓ <br />Mail Address <br />Mall Address <br />n/,Y ( i��sr � <br />City <br />Cily <br />State/Zip <br />g � �-�-�� <br />� p.yc-S'-�u a <br />�z� zsa�6� <br />Phone <br />Phone <br />�'u�n�f� �i���>.�r�� �r /?D� �� �,��Y' �f�/,�1 t�/�- 9'�'vSj/-o,z��' <br />Electrical Conlraclor Mail Address City State2ip Phone <br />�'C�Guci� Zo .�''y;%� <br />Slate License Number <br />�, ° <br />:�� S� o�r ...-C` <br />Proposed Use of Building <br />�.i O L� .�`� .IJCs <br />Contracl Price of Work <br />C'Nw� ,�' <br />�lac: - z zY- �.�i % <br />Contact Person (Plan Review) <br />Descripliono(WorkloDeDona: �is�S/(i%/+< ,SL`/G! ��7� c�/���c�.�rr-,�c�wg� � �o%�7�iv,(,G.- <br />. <br />� ��o+c�,�o .C. GU��'<��> <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABIE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 her�by cerii/y fhaf 1 have read anr ���amined this app/ication ond know fho sarno to be true and <br />correcL All provisions o(/a�vs anc; n�dinances go��erning this type o( �rorh will be complefed <br />whether specified herein or noL Tho prontin� of a ponnd does not resume to give au0ionty fo <br />violafe or cancel the provisions o/:+ �y other state or Iocallew rec�uPting consWchon or fhe <br />performance o! conslniction. Tha! ' am autho�ized by fhe o�rner o� fhis properiy to perfomi the <br />�vork (or which applicnfion is mado and 1 cornpty tvith fhe Sfafe Centracfors La�v 18.27 RCW and <br />296.200 WAC. <br />;:�� r/� � -�.�- �/ �/.y <br />FEE <br />