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ELECTRICAL PERMIT APPLICATIOfV <br />CITY OF EVERETT PERPIIIT SERVICES <br />.;200 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 />�a'�1 �C�a�=Lf=+���'"�.-- <br />PROJECT ADDRESS <br />t����/ ��:>�.1 <br />ow�er <br />Tenanl <br />6'Ji��i �vn��r <br />Electn:al Contrador <br />Mad Address <br />Mail Address <br />�a f3:� (530/� <br />Mail Address <br />V�V���i �lC OIk-N'. _ <br />State License Number <br />{�—�`�1 i�i`lv'� f�-�t <br />Praposed Use of Bwlding <br />� I'�5 :� � <br />Gty C �� � State/Zip <br />City <br />City <br />Stale/Zip <br />Slate2ip <br />C�s� <br />a-,�/l _ <br />Phone <br />Phone <br />(��) <br />��-v r^�.; <br />Phone I <br />��l,�bo - <br />Contrect Pr'ce of Work <br />Contact Person (Plan Review) <br />Descriplion of Work to Be Done�. ^�CC �'1�L �C1C I S� l N -�L� J<<-t� � l�c �� � <br />'`�" P I U 11: �5�1 r� l., � t�C �) CT� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN FACEWAYS, MC OR AC CABLE. <br />I CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br />� I hereby certily that 1 have read and eramined Ihis applicalion and kno�v fhe same fo be f�ue and <br />correcL All provisions o//a�vs and ordinances goveming fhis type of ��ork �vdl be compleled <br />! �•,hether speciGed herem or not. Tbe grantmg ol a pemvf does notP�esume fo give aufhonty fo <br />Ivrolate or cancel fl�e provisions ol any other stale or local la�v regu,ahng consfn¢tion or fhe <br />per/onnance o/ consfnichon. Thaf l.am authonzed by (he onner o/ fhis property to peAorm fhe <br />� i: oik /or n�hrch applicalion is rnade and I compty �vifh the State Coi tracfors La�v 78 27 RCW and <br />I 296 200 LYAC. <br />FEE <br />�a�oa-a�b <br />