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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - �AX 425-2E7-8857 — www.everettwa.org <br />APP�ICATIONS ARE ACCEPTED FROM S AM TO 4 PM <br />�I ma a 5 e a. h u rs-� �cJe,n�— <br />PROJECT ADDRESS <br />6 _ (.� �— I Z <br />��Iz06-0'Z <br />Pa�� Thompson <br />Owner <br />Mail Address City State/Zip Phone <br />Tenant <br />Mail Address <br />Ciry <br />State2ip Phone <br />(�er�,rmc�n�e, EI�Ctri �3u� aF�and P� 14'�U ���n��ord q8a9a <br />MailAddress Cily S�ate2ip Phone <br />Electrical Contractor 3(t D -5—'b� - <br />P�-�e Fo � �t i �1DR <br />S�ate License Number <br />Res�c�enc� <br />Proposed Use of Building <br />Description of Work to Be Done�. <br />� <br />� NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO <br />j BE IN RAC[WAYS, MC OR AC CABLE . <br />CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br />qooa oU <br />CoMract Price of Work <br />�a�/l�'lil� �(Y!7��.�1 <br />Contact Person (Plan Review) <br />1 hereby cenAy fhal 1 have read and examined Ihis applicalion and kno�v fhe samo fo Ge frue and <br />correcL A�I provisions of la�vs and ordinances goverrung fhis lype of �vork will be completed <br />v o�latocorcancel� ie prov� ions ol areiy ofher�9tatea P 1 catldovsegulat/ ng consfr9c6on�or f� e'� <br />peAomiance ol construchon. Thal 1 am aufhonzed by fhe o�vner of fhis property fo perlomf the <br />�rork lor u�hich app6cafion is made and I cornplY n�ifh the Sfafe Con(ractors Law 78.27 RCW and <br />296200 WAC. <br />vCk ��ZZtj�'1 (p—U—! <br />FEE <br />50�' <br />� 12��' OI Z <br />