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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.everetlwa.org 1� a-� 1 Z <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />��� � �-iAr c�e.5or �-� - <br />PROJECT ADDRESS <br />Te�hh� <br />Owner <br />rQ�,�.� <br />Tenant <br />� <br />� 1� rJ � �Iu(�25''n I`� � V�'C <br />Mail Address <br />( �-k+VdeSon <br />Mail Aidress <br />Y;-l�or �nC N��. i'�dr <br />Electrical Contractor Mail Address <br />T��(�y"` i32,, I-► <br />State License Number <br />Proposed Use of Bullding <br />Description ot Work to Be Done: <br />ceP+�,c��s fi a��a-�. <br />KG <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 />1 here6y certify that 1 have read and exemined this applic <br />correct. All provislons o( laws and ordinances goveming <br />whefherspecifled herein or not. The granting of a permil <br />violate or cancel the provlsions oI any other state or Icea, <br />performance o(construction. Thaf 1 am authorized by th� <br />work for which appllcation !s made and 1 comply with the <br />296.200 WAC. <br />l !�/% ,%� <br />Clty <br />Ciry <br />City <br />a <br />[�-IZO� —�°� I <br />�����3 .. <br />�,✓,� y� a 2 3 �� � 0 <br />S��Ip Phone <br />A �1 Y <br />State/Zip <br />c1 g �'1 <br />Slate/Zip <br />2�1. p (J O <br />Contrect P�Ice of Work <br />Contact Person (Plan Review) <br />dk.ie�+w <br />I� GJh.� e7 �"� <br />a to be true and <br />complated <br />ve authority to <br />tion or the <br />'o perform the <br />�8.27 RCW and <br />543- �bb <br />Phone <br />Phone <br />f2e. �OCo.��¢. <br />FEE <br />��ao�-t��� <br />