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c ; <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES . <br />3200 CEDAR STREET, EVERETT, WA 96201 �� <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />—Illb �✓nl( S�� <br />PROJECT ADDRESS <br />�I � <br />WI�Il4A� � <br />Owner <br />Tenant <br />h <br />Eleclricat Conlractor <br />Stale License Number <br />rPs��l��.��t l <br />Proposed Use of Building <br />I Ol� 0�' ���ai'�' R�. <br />rwan r+aaress <br />Mail Address <br />wv�Qr <br />Mail /1Jdress <br />Shvku a, <br />Clry <br />Cil�. <br />Clly <br />� <br />State/Zip <br />�t'S�L�6 ti1�-330- <br />Phone y�3 <br />SIa1c/Zip <br />� IUuo,o� <br />Conlract Price of Work <br />Conlact Person (Plan Review) <br />Phonc <br />Phone <br />I I � L <br />ci�riionofWorklo�eDone: Y�C4.ItP WhQ�Q nCLrhf� '�'`1 GI�MI'4,,,1 L <br />�f 1� I � - � — <br />0� �hV� <1H�� �l/yP �v0.� �r� C\�S���w. CtrGh.��1 �A�tl �O��e <br />. . lr <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certily fhaf 1 have : ead nnd examined this application and know (he sarno to be true and <br />cermcL Alf provisions o/la�rs and oniinances goveming fhis type ol work n�ill be completed <br />whefher spealied herein cr noL The granfing ol o pormrt does not presurno to give authonty fo <br />violafe or cancM fhe provisions ol any o0ter state or loc�l law regulatiny consWction or the <br />peAemiance o/ conslruction. Thnf 1 am authorized by Iho o�rner o/ fhis property fo perlomi fhe <br />work lor which application is made and I cornpl�� wilh the State Confracfors Lew f 8.27 P,CIN and <br />296.200 WAC. <br />�1��, LI'.u_ i,v�i..� <br />I�/�, <br />�, � <br />FEE <br />���) L' �1� <br />� <br />