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ELECTI�ICAL PERMIT APPLICATION <br />CITY OF EVERE't'T PERMIT SERVI�ES <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 <br />�7 2 � V�r.t r.1.��5.7 �% o'f� (111J I`i� � � <br />PROJECT ADDRESS <br />Tw+i <br />Owner <br />Tenant <br />Tm2 <br />Electrical <br />Stete License Number <br />�� ti� <br />Proposed Use of Buildin� <br />�qya7 6• Lr�/�.c San+� <br />n JGw-V N� ! <br />Mail <br />Mall Adaross, / <br />'14j'U7 E. L+�+c �!t{ri� <br />Mail <br />Gly <br />Cily <br />City <br />�( --5 �b"7 <br />� 070�(-060 <br />SlateZp <br />VA- <br />� 2S <br />Slale2lp <br />r1� <br />S�� <br />Conlrect Prico of Work <br />ConlactPerson (Plan Reviow) <br />Descrip(ion of Work to Do Done: ,� pl ti7c[ � Nr � v�'�t��l ✓� Gr,l[� c�ieq—T��/Zd191'`'j a- <br />..kdde9�.0 1,��_s L f�i�.�� �' /�� /,sE,,. �-c /11Lt1�"�E n .� <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 />1 here6y ceni(y ihaf 1 havo r'eod and examined this application and know the same to be truo and <br />correcL All proNslons o(laws and ordlrrances goveming fhis type of work will be complefed <br />wltethorspecffied herein or noL The granfing o!a pomut does not resuma to give authonty to <br />vlolete orcance/ the provisions of any otherstate orlocallaw ro�uPeting construcfion orthe <br />pedonnance of consirucflon. That 1 am aufhonzed by fhe ownor o/ this property to perform the <br />work (or which application !s mado and 1 compty wlth fho Stafe Con(rac(ors Law 18.27 RCW end <br />296.200 WAC. <br />=Sy o <br />Phone <br />Phone <br />Phone <br />