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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <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 <br />`. �c .j� S�'�9 IJ U11S7 /JVL <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />A1ail Address <br />M11ail Addre=s <br />City <br />City <br />Slate2ip <br />Stale/Zip <br />Plione <br />Phone <br />(�✓c�S%C'F., /^ �rc/ F�L l30 S HyGV'y /_^^ !2 �� ��� STPvtHS l,t,�/a �i' /O IS��. <br />Eleclricai Conlractor �faii Address Cily StatelZip Phone <br />�,U L'ST/_'G'H ,�99�L'" <br />Slate License Numbcr <br />�6J� � <br />Proposed Use of Building <br />Description al Work lo De Donc: GU I I� ,/UP v /2 CC ( c� Pe � P <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />DE IN RACEWAI'S, Iv1C OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />GGOG, OQ <br />Contracl Price of Work <br />Centact Person (Plan Review) <br />I hereby certify thaf I have read and examined Ihis applicafion and kno�r (he sarne (o be frue and <br />conLcL All provisions olla�rs and ordinances ,qoreming this t}�pe o/ worlc will be cornpleted <br />mhefher specibeAlterein or noL The �ranfinc o(a pernuf does nof prestune fo give authonty fo <br />violate o� cancel fhe pravisions ol an}� ofher `s(ate or local la�r regulefing construchon or fhe <br />perfom�anca o! construction. That I am nuthorized by fhe o�rner o/ fhis property to peAorm fhe <br />�rork !or which application is ntaAe and 1 cornply irifh fhe Sfate Confracfors Law 18.27 RCIM1� and <br />296.200 WAC. <br />.�.Gc�'C�e. �-+R-- <br />nr /i ,�00 <br />r-ee <br />E �,��� _� � � <br />