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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 9f1201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� i �- e <br />, (�: � � � .� -;� ,, �r� , �-;���; �,,��� , �15� ��, ; <br />PROJECT ADDRESS <br />�� � <br />=Ct !��'�� � i, , i�'fl. � ,—� <br />� � �. � ���t , � � •i " �_ ��'i�C'_l�l <br />Owner Mail Address City <br />Tenanl <br />Mail Address <br />Cily <br />,i � <br />/' ����i� )� _ <br />State/Zip Phone <br />State2ip Phone <br />( I'7i � i j Z�� � I �•C�h �%�`-{.11b�G W ��f�C�l�.S \,�f. (/�Q�� '�`er. �j{y�b)yj <br />a <br />[ledrical Conlractor Mail Address Gty State/Zip Phone <br />��Y� �-ty1�lpc ?�y L!i <br />Stalo License Number <br />Proposed Use of Buildinc� <br />Conlract Price of Work <br />Conlacl Person (Plan R�view) <br />Doscription of Work lo �e Done: ���•- `� � `��'d� 9'wT I �' � ��; :i a�,� r��� <br />NOTE; WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CAF3LE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />! hereby ceriily Ihat I have read nnd exantined this application and kno�v the <br />conect. All provisions ol/a�vs and o�Tlinances goveming this lypo o( u�ork ir� <br />n-hefher specified herein or noL The gianfinc� oI a pernuf does nof �resume <br />VIOIBiC 0/' CiifICCI fIIC `n�ovisions ol any other sfafe orlocallew rec�u�ating con <br />perfonnance olcaislmcfion. ihut I am aufhoiized by the o�,n��o�rn�sn��n <br />n�ork lcr which applieafion is nmde , nd 1 eornply �rith Ihe Sfafe Centractors L <br />296200 INAC. <br />� ♦ 1' . _ '{ _ � 1 <br />L _ �-� - . -I - \ , , <br />e fo Ge truo and <br />complefed <br />�e aufhonty fo <br />110l7 0! i�1C <br />o perfomi the <br />8.27 RC W and <br />FEE <br />�IUI(� CL;�,; <br />