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� <br />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 />133� W est' Yh q.G�v U�ev (��2•- <br />PROJECT ADDRESS <br />�O S-t- U� C� U C'-�2-P-�'�" — <br />Owner Mail Addross City Slate2ip Phonc <br />jUc.- <br />�C. �\J��ras-l-z�c-4�d e l 5��3 lic�eyit�e �4�-.0 �I c���c �� �/F3�Yl zt'�6-�,6�t1 <br />Tenant Mail Address City Slato/Zip Phono <br />Conlrac�M Mail Address <br />i-i�l G�-I Y''� E19 �{� 4M '1 <br />�State License Number <br />�Te�Q Qo w e� <br />Proposed Uso of Building <br />Ciry <br />�— <br />StatefLip <br />Contracl Price of Work <br />� V�' <br />Conlacl Person (Plan Review) <br />Description of Work to Bo Done: ��m�P QO k12� T� uC C C� S'f" lZ.. V C'�"� Ovj S l�f <br />NOTF: WIRING IN NON•DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cetlily fhat 1 have read and examined this <br />correct. All provisions ollaws nnd ordinances go�n <br />whether specifiod herein or noL The granting of a <br />violate or cancel the provisions of any other sla�e c <br />perfomtance o! consfn�ction. Thet 1 am aufhonzed <br />work lor which application is made and 1 comply w� <br />29fi.200 WAC. <br />and know fhe sama lo be frue and <br />ype ol work will be completed <br />; not msume !o give authonty to <br />aguPling constmcfion or the <br />er o! fhis property to pudorm fhe <br />Contractors Law 182i RCW and <br />2./f S/o 7 <br />FEE <br />� 3S•tic� <br />Ev�o�-�`1\ <br />Phonc <br />� <br />