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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVIG'ES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.evereltwa.org <br />APPLICATIONS ARE ACCEPTED FROM d AM TO 4 PM <br />52� NA21'� lC �✓� <br />PROJECT ADDRESS <br />Owner <br />��L <br />Tenanl <br />M1tail <br />Mail Address <br />Cily <br />Cily <br />iz--I�o6 <br />C-o6 �-z_oo3 <br />y�zs-Zau-yoz 6 <br />�V�2 �� �/� 9 82v3 <br />State/Zip <br />State/Zip <br />Phone <br />Phone <br />�N�- <br />Electrical Contraclor M1tait Address City State/Zip Phone <br />�l� <br />Stale License Number <br />/� ��N � <br />Proposed Use of Buildinc� <br />Coniract Price of Work <br />Contact Person (Plan Review) <br />Descriplion of Work lo De Done: �>'-�{�/I � ��YGI�- `��u�`�/rT � �/1/'�E, /T�� �""" � <br />,�'N�% �%(%%C.�S ��i7:%l1�. <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 />FEE <br />I hereby cerlify fhaf I have read and examined this application and kno�v the same to be true and � �; U � 2 f,(; j <br />correcL All prorisions ollaws and ordinances govemmg this type of �vork will be comp/efed <br />whether specified herein or noL The granfing oI a permd does not prosun�e to c�ive au(honty to <br />violate or cancel the provisions ol any olher sfafe or local law re�ulafing construcfion or fhe <br />peiformance oI consfruction. Thaf 1 am aufho�ized by the o�sner ol thrs propeRy fo perfonn the <br />wnrk lor which application is made and I compl}� with the Stafe Conf�actors La�v 18.27 RCW and <br />296200 WAC. , � � , <br />� <br />2-/-�I �� <br />