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� <br />� <br />ELECTRICAL PERMIT APPLICATION <br />ClTY OF EVERETT PEF�MIT SERVICES <br />3200 CEOAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - �vww.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />2 z 1�SC C-�'�G iT lYWc.� �iy �- A1 2 <br />PROJECT ADDRESS <br />Owner <br />�,1aJ Address <br />Gly <br />State2ip <br />Phone <br />GZiCItAizn �• �o�'t .2�I JE LVr,REi7 �YY-1d.L W� 171z 1:�C1261T- WA y82U� <br />Tenant hlail AdCress City State.'Zip Phor.c <br />I'J1�� 1 JIL N SL'1<v�CC� �1��.� <br />[lectrical Conlractor t.ta�l Address <br />�f'TS I S � c �G�� <br />State License Number <br />Ccrt-„��+c�c�l / 5����� <br />Proposed Use of Buildi g <br />Descriptian of Work to Be Done: <br />NOTE: W IRING IN NON-DW [LLINGS IS RE�UIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Gty <br />_ yz7.33b. 316 �� <br />StatelZip <br />T�S. � <br />Contract Price of Work <br />�a.vn?k s a �T <br />Contacl Person (Plan Review) <br />1 hweby certily that 1 have read and examined fhis application and Nno�v (he same fo be 6ue and <br />correct. All provisions olla�vs and ordinances governmg Ihis type u( aork �vill be cornpfeted <br />whefher specdied berein or noL The gianhng ol a permd does nof uesurne to give aufhonty fo <br />violate or cancel the provisions ol any ofher sfafe or local law regulating cons(ructron or fhe <br />peAoimance ol construttion. That 1 am aufherized by fhe owner o/ fh�s p�operty to peAorm the <br />work !or u.hich applicafion is made and 1 comply with fhe Sfafe Confrac(ors La�v 18 27 RClNand <br />; <br />Phone <br />FEE -- ----- - — <br />�vo <br />Ei�o�{- °�3 <br />