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ELECTRICAL PERMIT APPLICATION <br />CITY vF EVERETT PERMIT SERdICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ���� .�(7� <br />� L� /� <br />/ � I �' SE/l�-�v�S�% / \v'�' <br />PROJECT ADDRESS <br />�.��.s� <br />� iii� Ji=>�1-14!E y(o�� .`�c7arautsi �t�'L� �✓rYC�TT V✓✓� `�,�203 ZSZ��l7G��3 <br />Owncr A9ail Address Cdy StaiUZip Phone <br />Tenant <br />(/✓"/Qr"UJo�ICS <br />Eleclrical Contraclor <br />Mail Address <br />nz�c_ _j�/ZS <br />r,t,a no��«ss <br />w�rcwcs�;yo��� <br />State License IJumber <br />(Z�Ii�ENj ]faL <br />Proposed Use of Ouilding <br />City <br />�Z�r <br />Cdy <br />StatelZip Phone <br />i�ac_ w�, yBnrl i3g u�s <br />StalelZip Phone <br />ConlreG Price of Work <br />Conlacl Person (Plan Review) <br />Descriplion of \Nork lo Ge Done: (�� L f'/a I✓Z DA/'1 A4 � I t� M/��7 i On/ O U�=D2}-1EY�(i <br />✓� <br />NOTE: VVIRING IN NON-D1h'GLLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EV6<(cTT LOCAL SA'_ES TAX CODE IS 3105 <br />I hereby ce�iily B�:�f 1 hnve read and examinc:d Ihis applicafion and kno�r fhe same to be true and <br />conecl. All provisions e/la�vs and ordinances govern�ny fhis fype ol wcrk �vill be complefed <br />tvhefher speci/ied hcrein er not The granfing o! a pernuf does not resume fo givo au0�cnty fo <br />vrolafe or cancel the pro��isons of any ofher sfate or /ocal law reguPting consfruct�on or fhe <br />performance ol consfrucfron. ihat 1 am authcrized by fhe owner o/ fhis property to perlorm the <br />work lor which applicafion is made and 1 comply �t�ith the State Con6acfors Law 78.27 RCW and <br />296200 INAC.� j <br />� / ;� <br />��;.�� �G //2-�i c.� L�'- C� 7- G� ; <br />FEE <br />.. 1��� i; c1` <br />