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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 />�D(�'�- l�aSSa-�f <br />r�� �.`'� �?_:+-!-� C,��r.��"'j' <br />PROJECT ADDRESS <br />�a --i� -i� <br />Eiaia--o6z <br />�U�(Zr�f <br />�(��,� �� a�,�us�i��J �C .IIRr��oi�Sr2�r ��(i MStJ CoM� ZcE-`!7Z-��,�,2 <br />Owner <br />Mail Address Cdy Slate2ip rnun� <br />�_ <br />Tenant <br />� M --� �.. <br />Electnca Contractor <br />Mail �ddress <br />Mail <br />City <br />Cily <br />Slate License Number � ��'-' <br />I� <br />� Ni i� �C �-s� ��7 l� J j A- �„� �- Z��,-� <br />Proposed Use o( Buildinc� <br />Descriplion o( Work to Bc Done: <br />f . . <br />{�1` f�1 6141 C-� 5 � <br />� <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 />State/Zip <br />StalelZip <br />Phone <br />�-12'> M1�`E <br />Phonc <br />i� o ea �^° a'� 0{�rk � <br />Contra t Price of Work <br />Conlacl Person (Plan Review) <br />t��,. Y,rS !'���Yt ( �,:�ru� -L' <br />. . , n P —� � . <br />1 hr:�eby ceriily 1Hat I have read and examined fhis applicafion and kno�v the same fo be frue and <br />crrrecL All prowsions o/ laws and ordinances governuig this fype o/ work will be. complefed <br />whafher specdied herein or noL The granting of a pennd does not reswne to give aufhonty to <br />violate or cancel fhe provisions ot any otlier stafe or local la�v reguPting construcbon or the <br />performance oI consfrucUon. Tha� 1 am authonzed by fhe o�vner o/ (his properiy to perform fhe <br />work lor which applicafion is made and I cornply �vith B�e State Confrac(ors Law 18.27 RCW and <br />29G.200 WAC. <br />�/� <br />FEE <br />L 6oG� <br />� �21Z� bC¢% <br />