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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCFPTED FROM 8 AM TO 4 PM 5`�-� �� <br />.� < <� ji�.�.�:i:s:.�. ���� �� i� C c �, :r+ �"1,��<< <I <br />PkOJECT ADDRESS <br />M�� <br />��l_[I•t:�.l l�tiii; �(��S.�t<«��I�wS6. li� �uit i��1 1 <br />Owner Mail Address City <br />��A ,'i�"��� 4Zs �s� 7�S <br />State2ip <br />Phone <br />�iti��.� i����c�. :�i'� i4S'� si Sw L��.�,�� �;.1 ��, `la� ,i t �,ts 7�z�14�� <br />Tenanl Mail Address Ciry Slate2ip Phonr. <br />�, a <br />�.���. E,�,���> C<,.,� 1�21,• S"��I1� f�l S��`I� A-z4 Fr.(e..�(��y �,��,��,�'�.�j �;9•`i42_3e-�' <br />Electrical Conlraclor Mail Address City Slate2ip °hone <br />Sl �� i��Cz ( ," L�y3"L <br />State License Numb �r <br />Proposed Use ol Building <br />Deseription o( Work to E3e Done: _ 1��� <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 />L �Doc . _, <br />Contract Price of Work <br />Contact Person (Plan Review) <br />1��• III�l1�h4CI�l� �I <br />1 hereby certily Ihaf I have read and exarnined fhis applicafipn and know fhe same to be Vue and <br />conect. All provisrons o/ /aws and eidinances governmg this type ol work will be completed <br />whether spcahed herein or noL The granfing o/ a pernut does nof resurne to give authonty to <br />violale or cancel fhc provisions ol any ofher stafe or local la�v ieguP(ing conslrucfion or fhe <br />peAormance oI conslruction. That 1 am authorized by fhe on�ner o/ Ihis properiy to perlomi the <br />work /or which applicafion is made and 1 compl}� wifh (he S(ate CoNracfors Law 18.27 RCW and <br />296.��� wA�. <br />,% �� I � , . l'�. �, ��-'z �, ��.. <br />S1gnaWre � Datc <br />FEE <br />