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ELECTRICAL PERMIT APPLICATION <br />CITY QF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETf, WA 98201 � Z�_p g <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org C� ��Z_OS� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�����=� lr� ��1��-I-rna��(� �av��,. <br />PROJECT ADDRESS <br />Owner <br />Tenanl <br />� `�� J1 C1 != <br />t.lail A�ldress <br />Mail Address <br />�C =1-hG. I3115 J jrh_ <br />M;�,I Address <br />' •-� ,-r,��;a�P <br />I i.�a. _. <br />ta:e Licanse umber <br />�Jl����� ��xC� (�t�(��1���� <br />� Propo �e Use o1 Building � <br />Description ot Work l0 6a Done: (_; j,� � ���_ ���C� �l��i � <br />NOT[: WIRING IN NOI�-DWELLINGS IS REQUIREO TO <br />B[ IN RAC[WAYS, Iv1C OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />cily <br />Cily <br />c��y <br />Slate/Zip <br />StateiZip <br />( <br />Phone <br />Phone <br />C��� <br />_ 9't,��i ���-���g'b <br />Phone <br />Conlracl Price of Work <br />� 2i IQ (�_� �.� J�.) ���'� <br />Conlacl Person (Plan Rewew) <br />1 hereby certily Ihaf I have read and exarnined fhis ap/�licafion and kno�v the sarne fo be true and <br />correcL All provisions ollaws and ordinonces govennng fhis fype o( work will be completed <br />whelher specified herein or not The granfing o/ a permrt does nof presume fo give authonty fo <br />violale or cancel fhe pro��isions o! any olher stale or local law regulefing consfruction or fhe <br />perfomi2nce o! conslrucfion. Thaf 1 am aufhorized Gy (he o�sner o/ fhis propehy to pedonn fhe <br />�vork tor which applicafion is made and 1 comply �vith the Sfafe Controcfors Leiv 78.27 RCIM1� and <br />296.200 WAC. <br />la <br />fEE <br />���� `2 (� � � <br />