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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SE:RVICES <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 />(5�� (Y1�D��;���,�11 �1�� Lv�crell �/�- 9�sZ�l <br />PROJECT ADDRESS <br />� `I�i � <br />�o.v11('� ����a:J�,Se�� IS�� �1c�c.������ C`'.r't� W%C��Zv� 1.$�72G <br />Owner Mail Address Clty Stale/Zip Phone <br />Tenanl <br />C� �� e �_ <br />Elecirical Contrador <br />Slate Licensc Number <br />��G>U�� -L. <br />Proposed Use of Building <br />�dall Address <br />n�a�i ndd; e�s <br />Description of Work to �e Done: �l <' C�` <br />Cily <br />c�p, <br />�c' 1 <br />Slate2lp <br />state/zip <br />Contract Price of Work <br />Contacl Person (Plan Review) <br />.�� nn„%e <br />CC h���t� y. -C (Y'r'� ��� C� , <br />NO1 E: WIRING IN NON-DVY[LLINGS IS FEQUIIZED l0 <br />BE IN RACEVYAI'S, ��4C OR AC CADL6. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />! bereby certily that 1 ha��e rcad and ez�amined Ihis appliaation and kno�v fhe same to be true and <br />cormct. A/l provisions o/ laws and orAinances got�erning this type ol woric will be completed <br />�vhefher speciGed hercin or noL The granfing o! a perrruf does nol �resurne fo give aulhoriQ� fo <br />��io/afe or cancel 0�e In�e�.isi��ns el m�y other state or local la�r rec�u�afing consVuchon or Ihe <br />pedomiance o/consfrucfion. Tht�t 1 aro aufhorized b�� Ihr o�tiner o/ Ihis property fo perfomi the <br />n•ork lor �vhich application is made and 1 conrp/�� uifh fhe Stafe Cwihactors La�v 18.27 RCIN snd <br />296.200 b1�AC. <br />,�„��� (��t-�� <br />l�- ` S - ��S'� <br />Phonc <br />Phone <br />FEE <br />r <br />l�-�''�j( � �c�{"7. <br />