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ELECTRICAL PERMIT APPLIC�►TION <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 � Z_ �� _d � <br />L12�j v C UL�j�'I 1�1/t <br />PROJECT ADDRESS � <br />.� <br />._1 �-, ��. � 1� �� w�.J �v� r� <br />Owner <br />A1ail Addross <br />� <br />Cily <br />�o, ��Szo3 y1a-�5°i-�z��� <br />Stale2ip Phone <br />�-� =.�:.1zr\C�G Lo,itii <br />Tenanl Mail Address City Stale2ip Phone <br />�.�N �� <br />Electrical <br />�L i /�-� � — <br />`.'lv [��L 1`i � UL <br />State License Number <br />Proposed Use o( Building <br />Mail .4ddress <br />�L� �J.4, c/�lou �oeS7So�'7 <br />Ciry Stale/Zip Phone <br />�� c> <br />��Z��-- <br />ConVact Price of Work <br />Contacl Person (Plan Review) <br />g E��T�'r9in1 G <br />DescriplionofWorktoBoUcne: /�i�a �'ti'�- �-���R��+�- (^��'H� � �`�' <br />!_riu vo �,-,� �,c � r� 3cc '�c�� Cr16x � r �o 0,2 C o,vTRoG <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 read and examined fhis app�%cation ond know the same to be true and <br />correcL All prov�sions of laws and ordinances governina this type o! �rork w 116e, cornpleted <br />whether specified herein orneL The �ranting of a pennd does not �resume fo g ve aufhodty to <br />violate or cancel ihe provisions o(any other state orlucalla�v regulating co.�strurtion or the <br />perlomiance oI construcfion. That 1 am outhorized by the owner of fhis prcperty to perfom� the <br />wo�k Ior �rhich applicafion !s made and 1 comply wifh the Stafe Confractors La�v � 8.27 P,CW and <br />296.200 WAC. � <br />�� ��t�Q-� � �Z `l S — p � <br />FEE <br />� aG� z-v�� <br />