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ELECTRICAL PERMIT APPLICATION <br />I CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 —www.everetlwa.org <br />�1�C� i ='��'� �� <br />PROJECT ADDRESS <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�� <br />ST i,'�- l,Jilt� �-1 `iZU� "���t ��Si= �'�Jr�'eil , v�/1 <br />Ovm�r A9ail Address Cily Slate/Zip <br />Tenanl A1ail Address Cily <br />[Iec �ial COnUaC10f Mail Address ���Y <br />�i/ � <br />Slalo License Number <br />Proposed Use of Building <br />Slale/Zip <br />SlalelZip <br />Conlracl Price of Work <br />�— <br />`1c�2�� <br />Phone <br />Pliono <br />Phonc <br />Conlact Person (Plan Review) <br />C17,g,�,��_ �OC-�j 5�.-�'✓,��� P��CL ;z� zvp���+!-' <br />Description o( Work l0 6e Done: <br />= SliY3�li- L��� A �0:-� � <br />NOT[: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, �v1C OR AC CABLE. <br />CITY OF EVERETi LOCAL SALES TAX CODE IS 3105 <br />I hereby certily fhal 1 ha��e read and examineA fhis application and knotv the same to bo Irue and <br />con�ect. All provisions o/laws and oidinances govemm� fhrs fype of �rork nill be cemple(ed <br />�vhefher speci0ed herein or noL The gr. nling o( a perna( does nol�vrsume fo �i��e aufhonty fo <br />violafe o� cmicel fhe prcvisions o/ any other stafe orlocal /nw re�u a6ng constn�cliai or the <br />perlomiance o/ conslruclian. That I am aufhoiized by the owner o/ Ihis properiy fo peifoirn tho <br />�rork lor which applicafion is made and 1 comply ivith fhe State Confractors La�v 18.27 RCIN anA <br />29G.2U0 A �. <br />-,1'� ���" `�— /Z�%�� <br />c <br />FEE � <br />6 ✓ <br />�1112�0(�`� <br />