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ELECTRICAL PERMIT AF'PLICATION <br />CITY OF EVERETT PERMIT SER�'ICES <br />3200 CEDAR STREET, EVEP.ETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.ora <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />� J/ , �. ( ( �. <br />� �. J <br />PROJECT ADDRESS � � <br />, <br />;, <br />.�: �,�o .�- ��� �.,.. <br />Cr:ner tdail Address <br />G`���-�,�1 <br />C�ty <br />n �ir <br />Tenant Mail Address Ciry <br />(� G✓.L' • <br />Gleclrical Contractor Mail Address Ciry <br />State License Nuntber <br />-roposed Use af l3uildiny <br />7escripticn of `Nork to Be Done <br />_ /: _ f� z_ . :>_„ <br />;�^.��1 % <br />C��}� <br />Sate2ip <br />Stale2ip <br />State/Zip <br />Cortrc: Frice o( Worh <br />Con,act Person fPian Re:-iew) <br />/ <br />�,�. G-i� .�! - , <br />I /✓P-..r/ �;�i r S�ly> Ll � ��C�J <br />vUTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />� CITY OF EVERETT LOCAL SALES TAX CO�E IS 3105 <br />I� ! r;ereby certif;� (hat f have read and examined this applica[icn and know the same fo be true and <br />'� ..�r, ect AI! provimons o/laws ano orainances goveming this type e/ work will be cempleted <br />. ,•:nc!her speci(ed herein cr neL The qranting ol a permd dces nof presume to give authontv to <br />� .iaa(e or cartcel the provis�cns o/any ofher state cr local law regulating construction or the <br />I aencrmance ol c�nstruchon. That I am authonzed by (he owner of this property fo perform the <br />' 1rr,; k Ier which application is made and 1 comply wdh the State Contractors Law 18.2i RCW and <br />' '96200 WAC. <br />FEE <br />�s z.sz z -`���' <br />Phone <br />Phone <br />Phone <br />� E �y a�t -C�s 3 <br />---- --- -- ----- <br />