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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES �-a7-oq <br />3200 CEDAR STREET, EVERETT, WA 96201 C� � r��� <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org L� O/ � <br />APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br />�13 0 /��F+��SFG,� �1��_ <br />PROJECT ADDRESS <br />/jAVIG QA1U��y 5I3� /✓�1��'-c,c fid�C_ �VE�E� !n/�' � 951-�3 YZj�Y3.�-9�ys <br />Ownef Mail Addiess Ci1y State/Zip Phone <br />Tenant <br />� <br />Matl Addmss <br />uDsN�L ,�N/�Y S�-U��S <br />ElecUical Contractor Mail Adtlress <br />City <br />^��� /:"RrN C% <br />C ity <br />State2ip Phone <br />, lt1,C. `T8�1/ �LS-yb','�lG� <br />State/Zip Phone <br />S lf NDA�S�/v =�� ��. co <br />State License Numher Contract Pnce of Work <br />S F��- <br />Proposed Use of Building Conlact Person (Plan Review) <br />/r��/;�ct.��✓/, �cF�,r �„/.�;u�r' ��/+ ,vEw laF� 0���,�� <br />Description of Work to Be Done: _ <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />EiE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />y certily that 1 have read ani <br />. All provisinns ollaws and <br />rspeciliedhereinornot. TI <br />or cancel tl�e provisions ol e <br />iance o/ construction. That <br />v a�INch aoplicafion is made <br />this applica(ion and know the same ro be true and <br />goveming fhis fype o/ �vork will be completed <br />�l a pemut does not resurne fo give authonty to <br />3fe or local law reguP6ng consVuchon or the <br />ized by the o�vne� ot this property to perfomi the <br />'v with the State Confractors Law 18.27 RCW and <br />�l (�L����a <br />FEE <br />�i�jvl -��� <br />