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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 4�5-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br />y 9.25 ���� �.v w �ll <br />PROJECT ADDRESS <br />yZS <br />�3� <br />?�AS <br />� IrG M C1IlJlL✓�f ��(/ <br />Owner Mail Address City SlateQip Phone <br />Tenant MailAddrass Ci1y State2lp !/� Phone <br />7 <br />�C�-,a �u ���, S�.s �H or f� A-�' Fv 9�-�0 � �� ���� <br />Eleclrical Conlractor Mail Address Ciry Stale/Zip Phone <br />f��'L�4�/�S lY� L l� <br />Slate Licensu Number <br />%t �� T S <br />Proposed Use of BuilJing <br />f��j���� � J;,�z 1���.sl�lrcTir.�U <br />Descnpibn o( Work to P^. Dune: _�� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, �,�C OR AC CADLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Contracl Price oi Work <br />Contacl Person (Plan Review) <br />! hereby ce�ii/y fhaf I have read and examined tl�is applica(ion and Mioro the same to 6e Iruo and <br />correct All provisions ollaws and orclinances yo✓eming this fype o/ work will be completed <br />whether specilied herein or noL The granfing ol a permd does not pmsurne fo gi��e aufhonty fo <br />violafo or cancel the provisions ol any otlrer sfate or local la�v regulafing construcfion or (he <br />pedormance oI cons7ruction. That I am aufhonzed 6y fhe owner ol this property to perlomi the <br />werk Ior whicli a�olication is made and 1 co,vipl}� �vilh the Sfate Conlracfors Law 18.27 RCW and <br />29G200 WAC. <br />1��,� �- �/ <br />f-EE <br />Y� Sv <br />Ev`�c`l-�!v <br />