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ELE�TRICAL 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 - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />•1-J u �V C�l�tt� Mrdl,� w !>> <br />PROJECI' .4DDRESS <br />Owner <br />Mail <br />City <br />,, S ���� <br />Slate/Zip Phone <br />�,�'ti1��`.:� �)lo S�. �„��t�i( w��3ct [..,�St ��L�CI'>,f t�la �i�'Z�k y��v`�yv-3��Z <br />Tenant A1ail Address Ciry State/Zip Phone <br />Electrical Conlractor Mail Address <br />/� �u1 S� l�l i� �l (�.�- �l bi- <br />State License Number <br />Praposed Use of Building <br />City <br />State/Zip <br />�'.�, �tiw <br />Contract Price of Work <br />/ •4 4 <br />Phone <br />Q� +��,��«. �2 �� -a�ti-k��y <br />Contact Person (Plan Review) <br />Descriptian of Work to Be Done: I J� S��1L� �� N�"� Gt 2L U 1� <br />�Z \ �1 \ �IVI� j 1 ilZ: 9 �i1°�t = <br />�1 <br />� � .1 J!, v�C I_ Siu,C�. ?N:KG <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceRifv that / have read and examined this application and know the same to be true and <br />correct. All piovisrons of laws and ordinances goveming this type o( work �vill 6e comp/efed <br />�vhether speci6ed he�ein or not The granting ol a permrt does not presume to give authonty to <br />violate or cancel the provisions o/ any other state or loca/ la�v regu/ating construcfion or the <br />peAormance of constrocLen. That I am authonzed by the owner o( this property to peAorm the <br />work (or which application is made and 1 ccmpty �vdh the State Contractors La�v 18.27 RCW and <br />296.200 WAC. <br />�:"� Il ��'f'0�-- �L���` �L - <br />/� �i`/Z '6 <br />