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�LECTRICAL PERMIT APPLICATICIN <br />CITY OF EVERETT PERMIT SERVICES <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 />�. �v2-� l-��'-�-r flJ � <br />i'ROJECT ADDRESS <br />/ 2 —� b� C� C`'I <br />��, �z--�3� <br />�� t-- P� A(-'T� ST "u-1- � 2-� N- <br />Ownef 1:foil AOdress City Slate/Zip Phonc <br />Tenant <br />I,-0dit Ad��C55 <br />City <br />StatelZip Phone <br />� A s }1� '���— P - O - ��� `71 `�� �.k_•�� y�� '33 � z3� <br />EleC�riCal CoM�ac�or Mait Address City Slale/Zip Phune <br />i�fZ�RS�E�i ����� <br />Slate License Number <br />�N� 1-� <br />Proposed Use of Building <br />Description o( Work �o �c Dar.e: <br />-r-E� N Ci � ►� � � (L <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIREG TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />cen�ly thaf I have reed and exarnined fhis <br />All provisions o� laws and ordinances gov <br />snetiliedhereinnrnof. Thr.orantinoola <br />�� O � � <br />Contract Price of Work <br />Contact Person (Plan Revicw) <br />N� c� / ea R �-� <br />�lion and knon"hr, sanie to be Vue and <br />Ihis fypc of u�or4 �rill be r,ompleted <br />does not presumo fo �ive aufharity fo <br />la�v regulafing consfmcfion or fhe <br />owner o! fhis Evaperty fo pedorm Ihe <br />Stafe Confractors Law f 0.27 RCW and <br />� Z, /Z4�J � �� / <br />FEE <br />':U�I�Z 13� <br />