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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 �D �Q-a� <br />425-257-8°10 - FAX A25-257-8b57 - �ti��.tiv.evereihva.org <br />�D�la—d� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� � ✓'� !/i7; '�; ��, ,�r ��. �✓e/%'7?' l, �t °v%�� <br />PROJECT ADDRESS ' <br />PCl_ L��l <br />Owner <br />Mail Address <br />Gity <br />StatelZip Phone <br />7enant / Mail Address City Slate2lp Phone ;✓ <br />� � ��luM;�t,�,Gi,�-rst��>-Gi , tlh5��73-rr��-; <br />����-�-� � ����, .� ���, �z��;�„��, _��P r��.-y d,�;�,�r�r-�,�. ya��� <br />Eiectrical Contrattor Mail Address City ltate2ip P�one <br />� , <br />: i/c,��.,��'�iC /� <br />State License Number <br />Proposed Use of Buildinc� <br />Descriptior� of Work l0 6e Done: /E �—' �J'. L. n�✓"r.�' <br />, � <br />n l <br />//i.�a.�clrt%'�C�� `tN�',1r°.i �LQ u��,<'ci) e <br />C <br />C <br />i <br />n <br />� 7��� <br />Contract Price of Work <br />Contact Person (Plan Feview) <br />NOTE: W IRING 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 />I hereby cerii/y that 1 have read and examined fhis applicatio.i and know fhe same fo be true and <br />� orrecl. All provisions o/laws and ordinances gocemir.g fhis type ol ��ork will be wrnpleted <br />whefher speci6ed haiein or not The granfinc� of a perrnif does not resume to oive authority to <br />i�iolafe or cancel fhe �rovisions o! any other state or local law reguPting constrocfion or fhe <br />performance olconstruction. Thaf I arn authorized by ihe owner o/this property to perlorm fhe <br />�vork lor which application is made and I comply wilh Oie State Contractors Law 78.27 RCW and <br />29G.200 WAC. <br />,v <br /><'� �1%% 1� <br />o-sv, r /i�u xI � <br />� _ _! / �. <br />� ( � <br />