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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES ��au—ii <br /> 3200 CEUAR STREET, EVERETT, WA 98201 L 110 �— ��� <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � � � ��� ���� <br /> PROJECT ADDRESS <br /> �-,.E � t a--• � YY� I1 ��1��('cE �'t- �`�c2� � 3�-�3 <br /> Owner Mail Addross Ciry Stale/Zip Phono <br /> Tenanl Mail Address Cily ��e/ZiP Phone <br /> k_�R�SS� � ��.�- � cQ (��x�i� '��7T �� 33S•-2�4/ <br /> [leclrical Conlraclor �4aii Address Cily Slale2ip Phone <br /> l��AsS �,-�—�,'��,3i2L� <br /> Slale License Num�er Conlract Prico of Work <br /> 4�-�cr1-1�1� G--,�21��� <br /> Proposed Use of�uilJing Contacl Person (Plan Review) <br /> Description of Work to Cio Done: � �rn 1 S � � 1+ '�1n'�� —L �'�,``� <br /> fi'-fl 2 � - <br /> IJOT[: WIRING IN NON-DWELLINGS IS R[QUIRED TO FEE <br /> I BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �I � ��� _ 'L�y <br /> , 1 hereby ceriily Ihat 1 have read and examined this applicntion and know the same to be Irue and <br /> correcf. All piovisions olla�vs and ordinances�o��emuig fhis typo o/tirork u�ill Ue complefed <br /> whether specified herein or noL The granting o/a pernuf dces nefl�rosume to give aidhonty fo <br /> t�iolafe ur cancel fhe I�rovisions oI any afher s(afC or local la�v rc�u afing consfruclion e�the <br /> perf�miance of censtniction. TNat 1 am authorized by the o�^ner o(this property fo peiturm Oi� <br /> �vork!or �vhich.vpplicatiun is nmde and 1 cornply u-ith(he Sfate Centractors La�v 18.27 RCLh and <br /> 296.200 INAC. <br /> _��� y �� � ��� �� <br /> Si�na ur� e �� Uate <br />