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� <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 �" ��—� <br />425-257-8810 - FAX425-257-8857—www.everelIXUD.R�g �/oo8—d�3 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />-�a � � � �zv��.c�l /�'4-e! Gv�..�, <br />PROJECT ADDRESS � <br />Owner <br />(�/,�!>� �-i� <br />Tenanlr— <br />, <br />/)i1�1ll�Plc.r i <br />Eledrical Contractor <br />Maii Address <br />Mail Address <br />✓✓� r� <br />Mail Address <br />�,c�11}i���Hl��/,j L�G <br />State License Number <br />Proposed r se of Building <br />N� �lb" ��- • � <br />City <br />ver�tf iha..., r',�R �Ue� <br />City � <br />l7/9y tje�inet/ l��� <br />City <br />Description of Work to Be Done: 1'�•��� ra-� � %" ?c.. )/�/ re <br />NOTE: WIRING IN NON-DWELLINGS IS REQr IRED TO <br />BE IN RACEWAvS, MC OR AC CABLE. <br />CITY GF [ VERETT LOCAL SALES TAX CODE IS 3105 <br />StateANp <br />StateMip <br />Phone <br />yas - ai:�- a ��a� <br />Phone <br />360- 8vrs <br />CeJN /�3 � <br />State/v,ip �/�2-9J Phane <br />� �.�� <br />,� O o� J • OO <br />Contract Price of Work <br />��lC! FJc'�r f1 <br />Contact Person (Plan ReviewF <br />n'l � <br />FEE <br />%5'. oS <br />l hereby certily that I have read and examined this application and know the same fo be true and i �— v�� <br />correct. All provisions of /aws and ordinances govemmg tl�is type ol work will be completed �l (�v <br />whec�erspec�Bed herein ornoL The granting oJa pennit does nofPresume to give authonty to <br />violate or cance/ the provisions of any othersfate or local la�v regu,ating construchon or the <br />perfonnance ol construcLon. That 1 am a�dhonzed by the owner ol this property to peAorm the <br />woric lor �vhich application is made and 1 compty �vith the State Confractors La�v 18.27 RCW and <br />296.200 WAC. <br />��.��. ":��' - ,y 1 , <br />����LL:-l�_ �CrZ'1�---- ��j��Lo/✓ <br />