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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 />r?_13 L L� /��� k; (�o .31 �� , <br />PROJECT ADDRESS <br />l'l',��r�����/����(�;�� �_�,���.�- <br />Ow�ef A1ail Address City SlalclZip <br />% <br />i' 7 <br />,2�//-t <br />Tenanl � h1ai1 Address �' iry Slate2ip <br />�// / "� ��I /i / <br />�(�i 1 `� �(f'G����( c/N-13 /U� ��iGG(�r�ov-C (xGr� C��'f ��rblcff'NC' <br />Ele lrical G�ontraclor Mail Address <br />/ _� I i�'.�-�__���� 7� �� <br />Stalo.License Number <br />� 1 <br />�� r' `_� C l��P. �i� I�tJ � <br />Proposed Use of Building <br />,� <br />DescripUan of Work to Ba Done: ���-����`���� <br />NOTE: WIRItJG IN NON-UWELLINGS IS R�QUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />��q�o6 <br />Eobaa-�7 <br />Phone <br />Phone <br />��i� ��� 77 <br />C{�y State2i��� Bhone <br />_ �-��3�5 <br />�iCJ C J �9 �� <br />Contract Price of Work <br />Contacl Person (Plan Review) <br />�- <br />!GE' �I G GG�/J�L� <br />1 hereby certi/y thaf 1 have read mid examined this application and kno�v the same to 6e true and <br />wnecf. All provisions of laws and ordinancas governing Ihis type ol work will Ge wmpleted <br />�rhether specdied herein or noL The granfing o( a permd does not presume to give aufhonty to <br />violafe or cancel fhe provisions olany other stafe or local la�v ie�ulating consfruchon or the <br />performance ol construchon. jhat 1 am aulhorized by fhe owrer o/ fhis property fo pe�forrn Ihe <br />�roik Ior which application is�7nad i and 1 comply �vith the Slafe C�ntractors Law iH.27 RCW and <br />29G200 WAC. / <br />� �r,-,�� <br />" Slgnature � <br />�i <br />FEE <br />1-�; \s7C% .,� -Cl �-i '� <br />