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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.everetlwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� <br />'� �.Z '"� kl.� /41 L�� f�1�Tl-" ��L U1�, <br />PROJECT ADDRESS <br />I/ -- 2 6_0� <br />�08// �-/3(� <br />I�I C t�� .i� j �1CTi ".�- <br />Owner Mail Address City StalelZip Phone <br />Tenanl <br />Electrical Conlractor <br />S,'N;>cL.� �3.� 2 r� <br />Slale License Number <br />A1ail Address <br />/�rC2Z <br />M1tail Address <br />/����ntZ I-1�,v5F <br />Proposed Use of Buildin� <br />City State/Zip <br />: �N �� y�'� ��. y� <br />ily Stale2ip <br />� /�c"`` <br />Contract Price of WorY, <br />Conlact Person (Plan Review) <br />Description of Work lo �e Done: �� �'� V.� _ �(� � L'� �(�� (� L N S d� <<- %l �G'{'L% <br />��'' �`= �NS�-k-LL i��E_TEi2. <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN R,4CEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certily fhaf I have read ond exarnined U�is applicafion and kno�r fhe samo to be Vue t�ntl <br />correct. All provisions ofla�vs and orclinnnces goveming this fype o( �rork �+•i116e complefad <br />�: hefher speci(ied herein or noL The granfing ol a permd does not presurno fo give authon(}� to <br />violate or cancel fhe provisions oI any ofher stafo or local le�a regulefing construchon or fhe <br />perfomiance ol construction. fhat I am aufhonzed by the o�rner o/ fhis oroperty fo perform fhe <br />work lor �vhic h applict+fion is made and 1 compl}� �vith the Sfafe Confracrors La�v 18.27 RCbV and <br />29G.200 WAC.� <br />� <br />`:;( _'�-- !-.:�L,.,� <br />FEE <br />Phone <br />Phone <br />�O� l 1 -� U'� <br />