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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 B AM TO 4 PM <br />11�z'). wvc'I n11wrt-u: Vieyz SrivL. <br />PROJECT ADDRESS <br />IsIRiL-17 <br />Mail Address <br />sCS <br />City <br />al <br />State/Zip Phone <br />Tenant <br />11tt-�ruEtIle (OC42 <br />Mail Address City <br />IhlteC_1r P,,1n11t� <br />State/Zip <br />tdW �53�5 <br />Phone <br />ZS3StJS T <br />Electrical Contractor <br />Mail Address City <br />State/Zip <br />Phone <br />4nPIl i VsErr, - <br />State License Number Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />`1 <br />Descdplion of Work to Be Done: IG �P t1i1�i L t l I C Q 11�QL'� 1OYIS z net�'A nl 5od Fo—e_ <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I have read and examined this a r nd know the same to be True and <br />correct. All provisions of laws and ordinancj6sd <br />ing this ty a of work will be completed <br />whether specified herein or not. The grantipermit does of presume to give authority to <br />violate a provisions of any othestarr local law gu/ating construction or the <br />perfo agqce of cor (ruction. at,� am by the� V o/this roperty to perform the <br />unrL nr uN�ich ann cation i.rianr�coth the -State ConlmCtOIS Law 18.27 RCW end <br />Ly Be <br />Date C/ E�lUf'5� ��� <br />