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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 /� _�( — I 7„ <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org ( <br /> C I �1 l� 'C�7 S <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> .� � i S o,�.�s ;q✓E_ <br /> PROJECT ADDRESS <br /> C:Nr4f��S� LU�M� �,2G►� o��s ,4vE �✓F/'-rxf w��r Y$�f-6Y� ,��fG <br /> Owner fdailAddress City State/Zip Phono <br /> Tenanl Mail Address Ciry State/Zip Phoae <br /> �nc� � ��� �+r�� ����� � Nz�� sr�w� � ��-� ��zy'z N�-�3��, <br /> Elecirical CoNractof Mail Address City SlatelZip Phone <br /> � �� �;;,,. <br /> �l:c�EE93(:� ,> <br /> Slate License Number Conlracl Price of V�brk <br /> I�ES(6`ENC� - <br /> Proposed Use of Building Conlact Person (P an Review) <br /> � B�►�C�, <br /> Square Foo�age (If residential new construchon, remodel or addi0on) <br /> Description of Work lo Be Done: W��'E �ElN Drltri.B�11� / �'��u'�� <br /> MJTE: WIRING IN NON-DWELLINGS IS R[QUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. �D� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 Geroby certify(hat 1 have read and examined this applicalion m�d kr.o�v Ihe same(o be frue and El Z 1 U � �"75 <br /> correcf. All prowsions dlar;s and ord.�nances govemmg fh�s type o(work tvill be completed <br /> �:�bether speci�ed heiein or noL The granfing o/a pemut does not presume fo give authunty lo <br /> violaln orcancel(he provisions oI any otherstate orlocalla�v regulaling const�ucfion or the <br /> perlomiance o/cons6ucl�on. That 1 arn mdhorized by the o�vnerof this property fa perlonn fhe <br /> n�o�k tor'r+hich application is made and f ccmply�vi(h the State Con(rac(ors La�v 18.27 RCW and <br /> 29620 WAC. <br /> ` ���ri - r� <br /> /J� ;6 � ' <br /> Signature �a�` <br />