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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR S7REET, EVERETT, WA 98201 r' `� �� <br />425-257-88 i 0- FAX 425-257-8857 — www.everettwa.org `� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �`b ���b5� <br />-� <br />47 �z � �v�,��G�s� �-�r- - v n, ��#- A- <br />PROJECT ADDRESS <br />Th� G, <br />Owner <br />Tenant <br />TirZ <br />Eleclrical <br />Stale License Number <br />� �� nl �'`> <br />Proposed Use of Building <br />z�r7 �.. Lrv1vc Sn�t+�. <br />o lc.�...��/ N�.- � <br />Mail <br />Mail Address <br />28'V7 E. Gr��c ��i�n+^'� <br />Mail <br />Cily <br />City <br />Cily <br />SWIe/Zip <br />1.� �i/ <br />State/Zip <br />7+-/ yZs=B`!�o <br />Phone <br />Phone <br />t y2s =yvy-�lo <br />Phone <br />111D <br />��� s <br />Conlracl Price o( Work <br />Contact Person (Plan Review) <br />DoscriplionofWorktoBoDono: V�bCG'I� �9n.-}- �✓�'���:�0✓ � Ccr[tL �c�r T��12��`'� + <br />In .r� i�./. �o'ti G-eti �-irni ' 2,� �,�E ne �-[ %�1��1_�+%� ��.n e�' I-D/1 <br />� <br />NOTE: W IRING 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 />1 here6y certily fhat 1 have read and examined this application and know fhe same to be truo and <br />correct. A!I provisrons of laws and o dinances goveming this fype o/ work will be complefed <br />whether specilled herein or noL The 7ranting o(a penmt does nof resume to give aufhonty ta <br />viola(e or cancel fhe provisions o/ any other state or local law re�uPting consfruction or fhe <br />pedormanco o( construction. Thaf I am aufhonzed by fhe owner ol this property to perform fhe <br />�vork lor �vhich application is made and 1 comply �vith fhe State Confractors La�v 18.27 RCW and <br />296.200 INAC. <br />---' '� / - 7 <br />FEE <br />