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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX425-257-6857—www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br />� � <br />�' !�I4�� ��.=� iA,� �l rtb"� i v�iL�'�1 <br />PROJECT ADDRESS <br />I����T '�i �r� <br />Owner <br />Tenant <br />Li17Z Z;i�� �c <br />Mail Address <br />Mail Address <br />�"�AYLi- V.tLLI ��. �V'� Y)Lj' <br />Ciry <br />Cily <br />V.��� ��� � �, <br />S�ete2ip Phone <br />State2ip Phone <br />'���.�JI 'llii�'i�'� LIt�IJ�L INC� �i 1).i�',�X �Jl_�� ia1_L�tirli.�iJ �'1��:� 51-�i .��.� .��c.i� <br />Electrical ConUactar Mail Address Ciry State/Zip Phone <br />�lv�{ �-�}�.�.�:C '�j �Y �� �-" •j <br />State License Number <br />�,_l ', � � l i IJ �'-l�. <br />Proposed Use of Building <br />� i <br />Descnption of Work to [3e Done; �'_ <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAfS. MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br />! here6y certrly thal I have raad <br />conecL All provisions ollaws d <br />whetlrer specified herein or not. <br />viola(e or cancel (he provisions <br />perlormancr, ol cnnsiruction. T <br />u�ork lor which applicnfion is m� <br />796 200 WAC. <br />�� ' L <br />,-��%� � ( �L��''� <br />1�,�, � Contrad Pnce of Work <br />fhis applicafion and know the <br />govemm,q fhis type o/ w,xir wi <br />�l a pemR dces no( presume <br />Contad Person (Plan Review) <br />: to be true and <br />canpleted <br />ie aufhonty to <br />!ion or Ihe <br />o pertorm the <br />827 RCW and <br />ii <br />� �., � ; � ��cJ'L � �Z •� �! �. L�ti i�- <br />Signalure Date <br />FEE <br />�� i 2- o�� <br />