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PROJECT ADDRESS <br />Tenanl <br />6lecirical <br />ELECTRICAL PERMIT APPLlCATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 � Z_-�c� �� <br />�425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />� C �7/ z'�SC; <br />APPLICATIONS ARE ACCE?TED FROM 8 AM TO 4 PM <br />L LC /3.?SA� S E <br />t,Aail Address <br />�3a s/� S . E �,�e.e,i..p� <br />Mail Address <br />J �-�+w �l,00 s . , <br />r�a�i ndd«55 <br />/�o �f�D /oo ias <br />Stale I_icense Number <br />� ��� <br />PrapoSCd U e o( 6uiliiing <br />Description of Work to �e Dom: <br />NOiE: WIRING IN NON-DW[LUNGS IS REQUiRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />City <br />City <br />3'f � <br />cny <br />StatclZlp <br />Slalcl"I.ip <br />��d�'�-C. W <br />�I1UOC <br />Phone <br />Phonc <br />�g�0. � ° -- <br />Contrect Prico of Wark <br />` --��_�;: �? a,«.� �i� <br />Con(act Person (f I�n Reviev+) <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ce�ti(y Ihaf 1 hcrve reod and c,�amineA(his ap�lication and know the same to be true rmd <br />corrocf. All piovisions ollaws and orninances yovommg fhis fypo o/ u�odc will bo complefed <br />�vhelhor spr,r.Jied herein ornol. The �7rmfinc� of a pennil does not �resurnc to yive autho�ity tn <br />viola(e or cancel (he provisions ol any other s!a(o or locnl faw rogul�tinc� construcfion nr the <br />pe�Inmtance ol constnrc.fion. Thaf 1 nm a�rthonzed by the o�vner o(lhis propedy tn per(omi the <br />wu�k /orwhich application is rnade and 1 compty tt�ith (he State Confractors La�v 1827 RC W and <br />29G200 WAC. <br />FEE —� <br />� �. �v <br />� <br />����_1� <br />