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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVcRETT PERMIT SERVICES <br /> 3200 CEGAR STREET, EVERETT, WA 98201 <br /> 425-257-89�0 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> j�00 J s�Y�i,Cf Ir /-�'t-C' _ <br /> PROJECT ADDRESS <br /> �,"f�'[��1L�� r� �'rW<< S a e 0 St�rilwrl�p�� C'V��Cc 96'� c./1 Y�l� ? °l1.J- y/d�- P7y <br /> Owner Maii hddress Ciry State/Zip Phone <br /> G1/«l/�hr � [�,(nc� s,,., �� ftz��a.,,o7� M'E" L'Y[�CETi•lv1 pt� r yzf.- yiP- i'77 <br /> Tenant Mail Address Ciry Slate2ip Phone <br /> i2� <br /> Electrical Cont�aclor Mall Address Ciry Stale2ip Phone <br /> �,�- s <br /> State License Number Contract Price of Work <br /> N�r,l�. lf4,r4 l�a:�c <br /> Proposed Use of Building Contact Person (Pian Review) <br /> Description af Work to Be Done: /c���-. : 4.d�-i�.+1 �� l4�^% c�J�� �-..� ���, p�tf"��� <br /> ,� I r� �l� �:4 c Z , �karr d� (:�i�d- <br /> NOTE: WIRING IN NON-DWELLING� iS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. , � � <br /> � � <br /> CITY OF EVERETT LOCAL SALES TAX CO�E IS 3105 <br /> I her�by certily that I have mad and ezamined this application and know the same to be true and <br /> correcf. All provisions ollaws and ordinances govemmg this type o�work will6e completed <br /> �vhether specAied herem or not. The granting oI a permd does notp resume to give authonty fo ' <br /> wolate or cancel fhe provisions o/any other state cr local law regu/ating construction or the /�� G C , �7//`\� <br /> P c�k/ora vh ch appl cation�s ade and/complyevith the State Contra�ctorsplawy18.27 RCW and C� � J�J " I <br /> 296200 WAC. ` .� <br /> � <br /> , C� <br /> c �- �� l /—� — y <br /> Si nature Date <br /> i r` L�// �'� <br />