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ELECT�ICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 – vnvw.evereltwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� 7i�1 �� �✓iVK! �TE�� I�i VL7 ��'c�'Z:Ti Lt�l4, �/`j: o;� <br />— � <br />PROJE�TADDRESS <br />J?%RDCcY H.h'lW�7iL�LlS�livi/�i�,1;� iW (C;!�t�X ��O`� /�'��KI�I<L. l.Jr� `� p�c.i3'12S-;�t <br />Owner � Idail AGdress Cily Slatc/Zip Phone <br />J �711; �' <br />Tenant <br />�dail Address <br />City <br />.. --� <br />Slatc/Zip Phone <br />c��.:r�� c� ,F��,,,E __ — <br />Electrical ConlraCtor Pdail Address City 31ale/Zip Phone <br />�J /�� <br />State Li�ense Number <br />_`2_�' � — <br />Proposed Use of Building <br />Con.rect Price of 'Nork <br />0���(J � L� <br />Con'acl Person (Plan Review) <br />Description of Work �o Be Oone: ��C- ) LW CC /L•1�)��l v j— '� �%�� j>,�_ �/-���i� --K1Jc i3 �'_T�' �r <br />1.vrti�il�:. ��_�rc�, /`i2o'��� �.�i7rl M�L�r�'» ttF�t�;�c��t. �.�i�;i�aes. <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br />I he�eby certJy thaf I have read and examined (his : pplication and knr�w� the same to be true and <br />correct. All provisions o/laws and ordinances govemm_q thrs type ol r ork �vill be complefed <br />�vhefher speci6ed herein or not. 7he granhng o/a permd tlr,es not prasuma fo give authority (o <br />��ioh(a or canccl fhe provisons o/ any cther sta(e or local la�.v regulafirp cons!ruction or Ihe <br />perfonnance of consivc6on. Thaf I am authorized by the osvncr oI fhis preperty fo peAorm the <br />work ior wh�ch applic�hon �s rnade and I comply wifh Ihe State Confr.ncfors Law 18.27 RCIM1� and <br />296.200 WAC. <br />ti <br />!� <br />FEE <br />� �(�o3-G�3 <br />3� <br />