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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />�125-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />i�yl M�Ki�T�o ��vv. <br />PRUJECT ADDRESS <br />��s.-io <br />�/00 3�-f�7� <br />Srrv�� ����,� � c�� Tr1 LL P'I �'I .�/ s.a-�+�► � <br />Owner Mall Address City State/Zip Phone <br />Ten2nl Mail Address City Stalc2ip Phone <br />�"i ZS <br />fzxGcPr�oti� �C �C�= c-�rt��L �L���a��z ��>� 3� 9`�9s3 <br />Eleclrical CoNreclor Mail Address Clly Slale2ip Phone <br />t�C�Cf'GI�I�Jll�v <br />Stalo Licensa Nur.ibcr <br />3- Gq �Z �jA�z�i � iz <br />Proposed Usa of Buildiny <br />Description o( Work lo De Done: <br />� - L� <br />/�-(��.J CoN SNZ�7-zoti/ <br />S � 3- ov�r-L�TS <br />NOTC: WIRING IN NO�-DWELLINGS IS RE�UIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OP EVERETT LOCAL SALES TAX CODE IS 3105 <br />� I /Z C:�l <br />Conlracl Price of Work <br />Tc,.r y�,ro M i S' <br />Conlacl Person (Plan Review) <br />1 hereby certi/}� th�f 1 ha�e read fmd examined this application and know fhe sarne fo 6e frue and <br />corr�ct All provisions o/ la�rs and ordinancos govem�ng fhis fypo o( �rork isill be complefed <br />whelher specilied herein or noL The granfin� ol a permd does nof rosurne fo give aufhonty to <br />violafe or cancef the provisions o/ an}� ofher sfate or local In�v reguPfing consfnicfion or the <br />pedormnnce o( consftucfion. That I am aufhonzed b}� fhe o�sner o/ this property fo pedonn the <br />work lor which applic�1fion is made ��nd I cornpty �vith the Stale Confractors La�v 1827 RCW and <br />296.200 INAC. � � — - - <br />3/IZ <br />FEE <br />^ ( / � r;: <br />� <br />�= � J <br />