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�LECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.evereltwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />'3 �� a�- (��.�:-� r� c.��, A�n_- <br />PROJECT ADDRESS <br />LVJ <br />owner <br />Tenant <br />f�L�- <br />Mail Address <br />Mail Address <br />(2Nc�-ccrc�u.ti f{vt- C�c•u-rl <br />Cily <br />City <br />9va�� <br />State/Zip <br />StatelZip <br />�_c _�c <br />� /UD!-0 ��/ <br />-�55'-c:7�ry <br />Phone <br />Phone <br />v.�c�z�-n�.L �.���Zz�Z I-75�)�a Se�l�" ('�. �c��Fvw� �bw� ���•797-L6ti`� <br />Eleclrical Contractor Mail Addmss City State/Zip Phone <br />ovi.rL�e� v�7t�_, <br />Stale License Number <br />Proposed Use of Buildinc� <br />`�� y <br />Sw <br />Contract Price ot Work <br />Contacl Person (Plan Review) <br />Description of Worh to 8e Donr.: /11�� � C.� i'� Cu • 7 %-� L � i C q'7 P�t �✓�/' <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 />1 hereby ceriily that 1 havc reaAand examined lhis applicafion and kno�v fhe same to be true and �_ �('O� �-� U�'� � <br />conecf. All provisions o! /a�vs and o�dinances goveming this f}�pe oI �vork will Ge complefed <br />�vhefher speci6ed herein or not The granting ola pernuf does not p�esurne to give auihonfy to <br />violale or cancel Ihe I�rovisions oI any other stafe or local law regulafing construcGon or fhe <br />pedormance o/ consfrucfion. That I arn authonzed by Ihe o�vner oI fhis property to pe�form the <br />work /or �ahich applicafion is made and 1 compty with fhe Sfate ConVactors Law 18.27 RC W and <br />296.200 WAC. <br />-�- iil�-�!l i �`I �lv <br />S�c�naturc �� Date <br />