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ELECTRICAL PERMIT APPLICi�TION <br />CITY O� EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425•257-8810 - FAX 4'25-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />7�F�S� K�rdc�- �- <br />PROJ ECT ADDRESS <br />,5 -- // /0 <br />E �;?�5�0�(5 <br />�6 -3; b --13G <br />7�h �c,✓ �- 71F,i%S �irrc�s� (2� � �— �!/eye� i�.; <br />Owner _�Gail Address Cily Stale2ip Phono <br />�y �� ti� ��,.: �y�, � c.��- '��,°�'�o�u?� .-e 9�0� � <br />�h/' <br />Tenant <br />� lil ��.� <br />� <br />Mail Address <br />Electrical Contrector Mail Address <br />t,�Kr7��l� y33 PI' <br />Slafe Lfcenso Number <br />Proposed Use of Building <br />Descriplion of Work to Bo Done: <br />�-7 v <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Cily <br />City <br />Slale2lp <br />Phono <br />�t`�- L�ih��w�od �d��� <br />StatclZip Phona <br />S`'�'-�'� 7 ��— � � � � <br />Conlrac[ Prico of Work <br />(� y M YN ^� <br />Contact Pers n (Plan Review) <br />. /"2 ^� �' .. e o <br />I hereby cerlify that I have read and examined fhis application and know tho somo fo be truo and <br />correct. �11 p�ovisions of laws and orclinances goveming this fypo o( �vork will be completed <br />�rhe(her specified herein or not. The granting o/ a permd does not presumo to givo authonty to <br />vio/ate or cancel fhe �rovisions o/any ofher state or local la�v reguldfing construction or fhe <br />performance o/ conslruction. That 1 am aufhonzed by the o�vner ol fhis property to perfom� the <br />�vork lur �vhich applicafion is mado and 1 cornply �rith tho Sfate Confractors Lnw 18.27 RCW and <br />29G.200 WAC. <br />F[E <br />/ % <br />D � O ( f � <br />i <br />�� <br />