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ELECTRICAL PERMIT APPLICATION <br />CI1'Y OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 I�`— I��� <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />�o6il�vo � <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />.`� Z S l /' ! � d/� SG�'1 ��'��e � � "L_ � �(/c��� � <br />PROJFCT ADDRESS <br />0 / �v n / /'�, <br />Gwner <br />�./� ��f <br />Tenant <br />�G(% / t.� c. <br />Eleclrical Contraclor <br />�✓�"�5` L`C_ <br />Mail Address <br />Mail Address <br />i�%f l� �1, 4 6 <br />Mail Address <br />�o v�o�,' 3z`�-3� �i'K�v1� %�/r`t �c <br />Ciry <br />Cily <br />Cily <br />Stale/Zip <br />Slale/Zip <br />Sta�e/Zip <br />Phone <br />Phone <br />Phone <br />Stale License Number Contracl Price of Work <br />�,in% jC � ,�'e vt-�-�.( ��i � ��2 v1 �C <br />Proposed se of Building Contacl Person (Plan Review) <br />Description of Work lo De Done: �/� � fG�'�`-�'( �Q �� � T �E'Q i�d G� �--' i�� ���{C'� <br />r,v����, «�r.v �:/�sti�qS�Nr/�is�o.s-�G/r»/� ����u�=fs-. <br />� , � <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY UF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I liereby cmtily fhat I have read and examined this applic, <br />correct. All provisions o(laws and ordinances �oveming <br />whe(her speafied herein or not. The granting o/ a pormit <br />violafe or cance/ fhe pravisions o( any ofher stafe or local <br />perforrtiance o/consfrucfion. That 1 am aidhonzed by the <br />�vurk !or which applicatior� i�s rnade and 1 comply �rifh fhe <br />296.200 WAC. , . <br />iow the same fo be true and <br />work will be complefed <br />eswne to give authonty to <br />ing consfruction or the <br />iis properfy to peAorm the <br />3ctors Law 18.27 RCW and <br />FEE <br />F UlD l l-cG � <br />