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ELECTRICAL PERMIT APPE_ICATION <br />CITY OF EVERETT PERMIY SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everetiwa.org <br />a - 7 ''3 <br />�i3oa-b`�q <br />qPPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />7.�-o E r «,,,� �1 �� z <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />Electrical Contractor <br />� SG v. � 3� � <br />Mail Adtlress <br />Mail Address <br />.ue�i,�..c Ef��,�� � <br />Mal Address <br />(r5P1i (,�N9�ee.�� <br />Stale License Number <br />S ,.�, ��c ,�:,.,� ( � <br />� Nroposed Use of Budding <br />Ci1y <br />Cily <br />Cily <br />ue,�- u% A `/�' <br />State2ip <br />State/Zip <br />.� sY V��� � <br />SlalelZip <br />/CC�'" <br />Contract Price of Work <br />�-o/ `�3S a�a <br />Phone � is <br />Phone <br />�1� ��.�7� <br />3 ic[7 �_ Phqne� 3C �� <br />`y i <br />IIAw�� �j^cw.� <br />Conlact Person (Plan Review)I <br />W�� pj r H+y� ,cCf� <br />da 9 s he=�- <br />Description of Work to Be Done: <br />f /�.z r h ,�G 1 j 1-' r n�r � � c..L�'...�� ���- �- <br />NOTE: WIRING IN NON•DWELLINGS IS R.:QUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE . �v G� <br />CITY OF EVERETT LOCAL SALES TAX CO�E IS 7105 <br />1 hereby certily thaf 1 have read and exammed �his application and know tbe same to be hue and �(�` _l -�� � <br />cc�recL All provisions o( laivs and ordmances govemmg tbis type of �vork �vill be complefed �JvC <br />�vhetherspecihed herein or not. The 9�antuig o/ a pemut does not presume fo �ive auU�onty ro <br />violate or cancel fhe provisions ol any other state or local lan� regulafing conSVuction o� fhe <br />peAomiance o� construction. Tha� 1 am authorized by fhe ou�ner o( fhis p�operty to porlomi fhe <br />r;ork lor �vhich apPlication is made and I compty �vith the St�te Contracrors La�v 1827 RCW and <br />: 9fi i00 WAC. <br />-5' <br />