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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX425-257-8857—www.everettwa.�rg <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />.�. � - ���JL� ,�t��(�� <br />PROJECT ADDRESS <br />�r -la-�a. <br />C/011-0 sy <br />��'r r�l �7�l�C�Su�'�l �;�3.� ���ti' !'-� � �F-,('e�7— jN� ��d' � `las-�� u=d � <br />Owner Mail Addrass Clly State2lp Phone <br />Tenant <br />Mall Address <br />City <br />State2ip <br />Phono <br />�.���F ��r:�r�'�� �, � !. -,TII � �� ��n�./��ucv6 i��i ��-�'9 2- ��s �g3-� <br />ElodriCal ConlraClor Mall Address City Stat=2ip Phone <br />�D�f�.I�3C�3 � Soo.00 <br />Stalo Licenso Number Contract Price of Work <br />��SI (?{niLT <br />Proposed Use of Building <br />CoNacl Person (Plan Review) <br />DescriptionofWorktoDoDonc: ����`� r����� �-'�T�eff /'^ll�; `ii�li T��'�L �'yS�Ilij <br />NOT[: WIRING IN NQN•DWELLINGS IS RFQUIRED TO <br />BE IN RACEWAYS, MC OR AC CAE3LE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereGy certi(y Ihat / have rend and exnmined this application and know the same to bo (ruo and <br />correct. All provisions o/laws and ordinances govenun� this typo o( work irill be complefed <br />whefher specilied herein or noL The granfing ol a pemid does not �resum� to givo aulhonry fo <br />�-iolafe or cancel the �rovisions o! any other state or iocal lmv regulafing consWc(ion or the <br />perfomiance of construction. That / am autho�ized by the owner o/ fhis property fo pedonn !ho <br />work for �vhich applicntion is made and 1 comply �vifh tho State Confractors Lotv 18.27 RCW and <br />29G.200 WAC. <br />FEE <br />,�1,�� ia�� 11-10-�� � p i/ � os� <br />---...__, �,_._ <br />