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E[�ECT�I�AL PERMIT APPLICA�ION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everet;wa.org <br />APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br />, > <br />�� 1 C� C`.vsz�•.Il i��� L`,�-� ; C�,..oZ.- iP'. V✓-� � Z�S <br />PROJECT ADDRESS <br />_�-� Tr�'�ti�-=,=��-� <br />0lvner M1tail Address City St�te'Zip <br />Phone <br />T ���� � <br />Tenant Mail Address City State/Zip Phone <br />� u L`_"- 3� 9=� I 7 I <br />5�.�....�.c,�o�i' �o�,.� 1�-2�z rsar�����-cL �� �-r� r�9 ���� c6t,d'u� �� 9�0�� <br />Electrical Contraclor Mail Address Cily Slate2ip Phone <br />�VF�.'l,ti,'b L.'�- � SS 5 �- z <br />Slate License Number <br />�l v� <br />Proposed Use u( 8uilding <br />-� Z C� O O. "�' <br />Coniracl Price af Work <br />Contact Person (Plan Review) <br />Description of VJork to �c Donc: .I_�-- S i-A( l_ \; ��� �`-�- �ASI� C'��L la� ` <br />� t10TE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I�.�_ieby cerfi(y that 1 have read and examined this application and know the sarne to be true and <br />necL Al/ provisions ollaws and ordinances govemmg (h�s type ol work wi!I be completed <br />hefherspeciLed herein ornot. The g�anting o/a permit does not pres��me to give aufhordy to <br />late or cancel the provisions o/ any other s(afe or local la�v regulating consfruclion or the <br />iformance o/consfruction. Thaf 1 am authorized by fhe owner ollhis propeRy fo peAorm (he <br />r.:vk /or which applicafion is made and 1 comply wifh fhe Sfate Confractors Law 18.27 RCW and <br />ti.200 WAC. . —� <br />! 1-1 �/- cS <br />FEE <br />.�d �. l � - � l � <br />