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t <br />� <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-Sd10 - FAX 425-257-8857 — www.everettwa.org <br />APPLIC�TIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�) <br />�� �/ t ��� � ��. . �, �.� r� �,� � L.�-e,-.e�-1� <br />PROJECT ADDRESS <br />Ib1rJr , I <br />Owner <br />i���,, , <br />� �� I l �-t � �r�•�� <br />City <br />��� I l l� � �(� �. � �. <br />Tenanl � h7ai1-hddress �D � ����Y <br />��� VIiL�- �,.lL�l- _'I-1(lii�l91 •,blj h��J/'CV`( <br />Eleclricai Conlreclor Mail Address I� I;Ciry <br />J� ^ <br />i�; �� �r�� i'� �1� � l�F <br />Slale License Number <br />Proposed Use of Buildinc� <br />f1��: �Vl�l"� �i,�� <br />Slale2ip <br />�'�-l� l-- � �Vti' � l''�I- 1� ��— <br />Slale2ip <br />,•� Cti'n- �( $ �258" <br />Phone <br />Phone <br />�%2 s �� j�i- �� <br />StatelZip <br />� �����, �� <br />Contract Price of Work <br />Conlacl Person (Plan Review) <br />Description o( Work to Oe Done: �U � rZ �-d �- `' �.. �� � � �V'�.' �•� Yl �!,) I. <br />NOTE: WIRING IN NON•DW[LLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereb}� certily fhat 1 have read and exarnined this application and kno�v fhe same fo be true and <br />correcf. All provisions o�laws and ordinances gorernmg this 1}�pe ol work �sill Le cornplefed <br />n�hefher specdied herein or not. The granting of a pennrt does nof n�esume to giee authonty fo <br />violafe or cancel fl�e uovisions o/an}� other state or local /a�r regulafing consVuctron or fhe <br />performance ol cons�ruction. Thaf 1 am aulho�ized b}� fhe owner o( this properiy lo perfonn the <br />�rork lor �vhich application is made and f compty �vifh fhe Sfafe Contracfors Law 18.27 RCW and <br />29G.200 IM1�AC. <br />�) ( � � � ��.� � � <br />i1;�� P �J � �'u�•f `�` 7 —� <br />FEE <br />Phone <br />C-AIO�—ol -�'j <br />