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EL_ECTRICAL PERMIT APPLI�ATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREGT, 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 />�3' �-C- 7 <br />/ j � � <br />L= //L /.;� �'.t7r[v- ��C�/ <br />PROJECT ADDRESS <br />Cr"v / <br />oW��� � <br />Tenant <br />, � <br />C '���SG•7 � 7 / <br />Mail Address <br />A1ail Address <br />S¢/r, �5�w 3��s, <br />Contraclor Mail Address <br />F�L�9A/SS /�/2 L-/° <br />Stale Licenso Number <br />�� S <br />Preposed Use o� Buildiny <br />i'/ni4�—�i% � L�'tG'L�� / �< <br />City Stale2ip <br />City Stale/Zip <br />Ciry <br />Z�/ <br />State/Zip <br />�_ G)?C�;l'-<-'��� <br />'J Z� — <br />z.;c� -riz � <br />��,��,� <br />Phone <br />yz > - 27i'- 7JG <br />Phone <br />�//^' \/ C�� <br />✓ �/`� <br />Contrect Price ol Work <br />Er/C�'� isr�„ �° ��z s-z3�=-i � < <br />Contact Person (Plan Review) <br />Description o( Work lo De Done: �C�7L� ��P ��IT ��"�"' `r ��� /7 � ' <br />NOT[: WIRING IN NON-D'�NELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certi/y fhaf I have read and examined Ihis applicafi.m and kno�ro� fhe same to be t�ue and <br />cenect All provisions olla�vs and ordinances governing tha fype ol trork �vill be completed <br />n�hefher specified herein or noL The �rarding o/ a pvrrnd does nol presume to givc aufhonty fo <br />violafe or cancel the provisions ol any otlier stafe or /ocal Iaw� regulating cunstruc6on or fhe <br />peAormance ol construction. Thet 1 am nufhonzed by the u�vner o/ th�s property fo perforrn (he <br />work /or which application is made and 1 comply with fhe Sfate Contractors La�v 18.27 RCLV and <br />296200 WAC� <br />/:��'- j�� . 3-z �" � <br />� <br />FEE <br />r���Clij �%(�) <br />