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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 />�%�,? l �i� ,� iAN�i (� <br />PROJECT ADDRESS <br />Owner <br />Mail Address <br />City <br />5�2-5 - 5�?�.5 = /�:t�/ 2 <br />Stale/Zip <br />Phone <br />Tenant Mail Address Ciry State/Zip Phone <br />/`%i ►�//� `I n �.a fC,--J� G��T �c � �viyCiT� �Yss =33 %-300 6 <br />9S .3 /;�57` A vE S, � 4. A- y,�'z4'R <br />Electrical Conlracto� Mail Address City State2ip Phone <br />00 <br />�^p✓/� �1� C? /-` `�1 G 2 /C ,-, / �O O "'_ <br />Stale License Number Conlract Price o( Work <br />� ,.n <br />' ' ��14-(Z/O .tJ L, . '%12A-W ` <br />�� %'�C' �'J ^. (`� � i �! � l,. U / l._ � /,'J(J— — <br />Proposed Use of 9uildinc� Contacl Person (Plan Review) <br />Description of Work to Be Done: /f / �/'Ll ti �� X�� O U_� �d/C-Li�"�C <br />NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />! hereby certily fhaf 1 have read and examined fhrs application and know tha same to be true and <br />correct. All provisions o/ la�vs and ordinances �overnmg this type oI work �vill be complefed <br />whefher spealied herein ornot Tlie granling ol a pennd does nof presume (o give au(honty to <br />violate or cancel the provisions o/ any other state or local law regulating consfruction or the <br />performance o/ construcfion. Thaf 1 am authonzed by Ihe avner oI Uus property to peAomi the <br />work Ior �rhich application is rnade and 1 comply wifh fhe Sfate Contracfors Law 18.27 RCVI� and <br />296.200 WAC. <br />_.�'— _ <br />��;�:-�- S =/S� <br />J . ^, <br />;� < `, _. <br />� � - 1� . : >...G'......�..`. <br />FEE <br />