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ELECTRICAL PERMIT APPLIGATION <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 ARi 4CCEPTED FROM 8 AM TO 4 PM <br />i� �� 1�/�=5 ��-I�,� �������;o <br />PROJECT ADDRESS <br />hIC.= <br />Owner <br />MaII Address <br />City <br />� r��V D �I )C';K! <br />SlaleRip Phone <br />�li�i-i� <br />Tenanl Mail Address City State2ip Phone <br />�'�� �Z��1 �-� C�► � c3'!o i.tVf I�i S�`� Sr ��e.l�,:� �I�31 7 <br />EleclricalConlracto� MailAddress Ciry Slale2ip Phone <br />(�� I r'�� �-�I 3J �'� <br />-9/S/Iz 2�6.zsS 4�,� r�c <br />State License Number <br />Proposed Use of Buflding <br />�iSr�o" <br />Contract Price of Work <br />Conlact Person (Plan Review) <br />Dascription of Work to Do Dono: ?(� f` i�1-i )1� I l,a �[j �, r� 1' �F � 111e �7L S� � <br />� J <br />1?� F'(�(-h l4G 1�5 /� L42C i 1-i� �, � C`U 1� � �" (`�� �� l'r-� <br />- ` T <br />f 1'iC � IZ'IL-� `�� i� j L11� <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 3705 <br />1 hereGy certily fhat I have read and exarnined Ihis applicafion and know the same fo be frue cnd <br />cormcL All provisions ol fa�vs and ordinances govemmg this typo o/ work will6e cornplefed <br />whether specilied herein or nof. rhe c�ranting o/ a perrnrt doos nof presume to give authonty to <br />��iolate or cancel the �rovisions o/ an}� ofher stafe or locnl law reguleting conshuction or the <br />peiformance o/ consfruction. 1'hat 1 am t�uthorized 6y the arnor ol this property to pe�fomi fhe <br />�vork lor ivhich applicatio�t.is-rr�ade and 1 compl}� �vifh fhe State Contrucfors La�v ib.27 RCW and <br />29G.200 WAC. \ <br />FEE <br />L ll c :; �-"�� <br />