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ELECTRICAL PERM�T 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 />( n ll S �/�s�l" �� <br />PROJECT ADDRESS <br />(��n��iS�E,v� ��r.3����5 I�GL ��r �" I�r 5(- L/CSi�✓�nJS ���f� ��i��4Y <br />Ownef Mail Address City Stale2ip Phone <br />__ _ _ (�/zs) �7� <br />cosa <br />Tenant Mail Address City °tate2ip Phone <br />l�r✓,,v� l�uc-�i�(L <br />Electricai Conlractor Mail Address City Slale/Zip Phone <br />Stale License Number <br />�( i� � ii�l."r��%}L <br />Proposed Use o( Building <br />i n �2 <br />Description o( Work to Be Done: ���� i l� l�✓1L <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRfD TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />c_" <br />% L7(�, <br />Conlract Price o( Work <br />i <br />�Ir>C ��'1t�ft.(._r,2 <br />Contacl Person (Plan Review) <br />1 hereby certily fhat I I;:�ve read and examined fhis applicafion and know Ihe same to be true and <br />coirect. All provisicns nllaws and ordinances govemmg this type ol work will be comp/eted <br />whefher speci6ed herein ornoL The �ranting of a pernuf does not resume to give aufhonty to <br />violafe or cancel the provisions �(any oth�r stafe or local la�v reguPting construction or the <br />perlonnance ol consfrucfion, inat I am aufho�ized by fhe owner o/ fhis propert}� to peAomi the <br />�vork lor which applicafion is made and 1 comply with fhe Stafe c, �nfractors La�v 18.27 RCW and <br />296.200 WAC. , <br />� '� �� /,,�,� �.�' �` . % it� " �_� �-, <br />�:---,..._ � i �.�„ <br />FEE <br />�O�O�t - ( Z� <br />