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ELECTRICAL PERMIT APPLlCATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA `!82G1 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � b � a�— <br />j �l nS �� �a,�,i.�e s��� R� . 1� /� % ,� ��=>'" � <br />��il�-4'-���=ri�F1:,-��tr�d--��—iv-'�_-�I—�r s L S- L� b <br />PRJJECT ADDRESS � ��J� <br />�-+zs-sn ��� � <br />T2� c ��� �s s cx ��� I c� �i5 Ncv sA c�t r�,t-x.�L� s+� rza � � �7 <br />Owner <br />U <br />Tenanl <br />Mail Address <br />� ss c <br />Mail Address <br />Ciry <br />Cily <br />State2ip Phone <br />�,S%�-C�l� l.�.G� <br />�2�2c�'s �%�pz� <br />Siale/Zip Phone <br />BA-(��( L� � l. �,Z�M�LC� �� c� Z� I n C./� ��.F. S r. L�(E�c�t �vi "� f�2.o I <br />Eleclrical Contraclor Mail Address Ciry Staie2ip Phone <br />4 2.�'Zs' Z-�f 7P 9 <br />1'�l� %1�1=�:Z. � `l C� b �� <br />Slale License Number <br />Fi� Tl� �, �'� � t�C-, S <br />Proposed Usc of �uildinc� <br />��— <br />Canlract Price oV Work <br />Conlact Person (Plan Review) <br />� NS'i1a a ��l c1, .S vi�.'f C�J �,v1� S r}t'u� �-' <br />Description of Work to Be Dona Z r.� <br />�� P�-£ S. N s-�a-c �1 n,; c)�' uc k- � �- P w 2 c u�G- . <br />NOTE: WIRING IN NON-DW[LLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />FEE <br />I hereby cerlily fhaf 1 have iead and examined this applicafion and know the same fo be frue and <br />correr.t. All provisrons ollaws and ordinances governmc� fhis type ol work will6e completed <br />whefher specdied herein or noL The granting ola pernul does not resume fo give authonty to <br />violate o� cancel the provisions o(any ofher state or local lmv reguPting constn�chon or ti�e <br />performance o/ construclion. That I am airthonzad by the owner o(Ihis property fo peAorm fhe <br />work lor which application is made and I comply wifh the Stafe Conlractors Law 18.27 RCIN and <br />296200 WAC. <br />' 7 � � �� <br />t <br />�/� ' /�L� <br />