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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 ACCEPTED FROM 8 AM TO 4 PM <br />�, � Z�� 1-+ �, ��scN 1"'r� 5 v �"TL= � <br />PROJECT ADDRESS <br />A �; <br />OWnef <br />Mail Address <br />Cily <br />Stale/Zip <br />�-9 -03 <br />�-�ifl /...a a-`� <br />Phone <br />1<paiM " ���ur� l� ���.s�-� _ <br />7enant hlailAddress city sta�� �3� C��G <br />,-�'i_ v' 7 c,2c.--��� 7�� i/lv'� Si'S• �vc�r� �,�.�A i�4��/�i <br />Electrical Conlracbr A9ail Address <br />L aJ c.sG- L��� C' S�5 rj'� � <br />State License Number <br />v's �u A,,.�,�- T�� �:,� Ki�'(3R /i _ <br />Proposed Use o( Building <br />City <br />Stale/Zip <br />Conhact P�ce of Work <br />� <br />Conlact Person (Plan Review) <br />� y1� lz �/.�' .!/l � <br />Descriplion of Work to Be Done: /�"7✓/rl�� //l� /��dN'in� i � <br />�-/(�isN�i.�/Ci � cSuJ�f"� ���.rsZ�F-�=s'r�i�'a�s•7✓'r � <br />MOTE: WIRING IN NON-DWELLINGS IS REClUIRED TO <br />DE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAI SALES TAX CODE IS 3105 <br />I hereby cerii/y Ihaf 1 have read and examined fhis application and know fhe same to be true and <br />conecL All provisions o!l,:ws and ordinances governing this type of work will be completed <br />whether speafied herem or noL The granting o/ a pemut does nof resume to give authonty to <br />violafe or cancel fhe �rovisions ol any olher state or local law regaPting consWction or the <br />pe�lorrnance o/ consfrucfion. Thaf 1 am authonzed by the owner of th�s propeRy to poriorm the <br />work lor which appliwfion is matle and 1 cornply with lhe Sfate Confractors Law 18.27 RCW and <br />796.200 WAC. <br />-D�- <br />PhOne <br />FEE <br />Z1z_ � <br />/ <br />��� - o �- <br />