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ELECTRICAL PERMIT AP'PLICATIOlv <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everett�•:a.org <br />APPLICATIONS ARE ACCEP fED FROM 8 AM TO 4 PM <br />�} y I 5 I� A� Of S 0 �J /ruo �-v.,-T,�i,� r��,,v pc.t�za) <br />PROJECT ADDRESS <br />I�iil".Li- /kz50ClATt S ILcS" A;�J .SRtwwlsl{- PJ. � I O�- I.`a5R QJAH �_�JA `� 80� `� <br />Owner ldail Address City State/Zip Phone <br />�4 vAUPv F�Srta��ca.�r �a�ti ��t5o,.� £��e�.tr wn AK�� <br />Tenant Mail Addicss City � StaieiT_ip Phone <br />��f�F� �l.�C1�IC r�Sld LAUF n)(F} _�1__�1�G_� �A)li ��01 4Z7 6S"h d�( � <br />EleciricalConUactof MailAddress Cily State/Zip Phone <br />f�AL�N�fL9`l !, RiJ <br />Stale License Number <br />Use ol [3uilding <br />��� � Q _ <br />Contracl Price of Work <br />�`��ey f,v�s 4as 647 a11G i���y <br />Contact Person (Plan Review) <br />Descnption of Work to Be Done�. ��)p F�PL Ii(.hE�vl �FV � F 1�.) AAOJ�� (�1� FJl1Y' -� I' I <br />r . ■ �. V� . i� . <br />' [ ' •a��r <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 />I hemby certily thal I have read and examined fhis application and kno�v the same to bo Irue and <br />coirecf. All provisions o/laws and ordinances qovemmc� fhis fype olwork will Ce completed <br />�rhefher speci(ied hernin or noL The granfiny o! a pennrt does nof presume fo give authority fo <br />violate or cancel the provisions ol any ofher stafe or /ocal la�ti� regula6ng constnichon or tho <br />pe iormance o/consfnicfion. That I arri aulhoiized by fhe on�ner o/ fhis propeAy fo pe�form fhe <br />a-ork lor which application is maAe and 1 cornply �vith !he State Contracfors La�v 78.27 RCbl' and <br />296200 lh'AC. <br />�� Q <br />FEE � <br />�b'-dD <br />— n-r�l <br />���_ � � <br />