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ELECI�RICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8510 - FAX 425-257-8857 — www•everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />/� <br />�? �' 1,1c5nDA�d/9�.�n1 i-i6'E,_c=vc«�iT <br />PROJECT ADDRESS <br />� ' � �.��' I � ��'E�2E7i 1_'/�i � �S?G� <br />la r' r� i, ��! � n c-, �� c �-� w n% .J v�� ,_ .� <br />Ownef Mail Address City StalelZip Phonc <br />Tenant <br />p7ail Address <br />City Statc/Zip Phone <br />//1V �Ci�t"� ��� LJ/I ����5 <br />�j���_;;,� � �) C NCk� S E�'Vi CCS /N /�i,� `J��1 G�KI L7F. SIVEc= ��ti�+`� <br />Electrical Conlractor Mail Address � City State2ip Phone <br />li��-� i�LJ �.��7� <br />A�)vA�� � SCG. ('i <br />State License Numher <br />�r<1 h "i�'Til� L <br />Proposed Use ol Ouilding <br />`�' � C� �1 � ) d C% — <br />CoNract Price of Work <br />L c�Nt1 �Z �!' r�/ I-1 L� �'1i <br />Contacl Person (PI2n Review) <br />Description o( Work l0 6c Donc: I F� �- P{ C E N) fi �/.l �� E c T li � C r1 L /%_ <br />�y� f�o � i2 C � i2 c <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR nC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby ceitily Ihaf / have read and examined fhis applicauon and kno�v the same to be fnie and <br />correcL All provisions o! laws and ordinances governin� Ihic lype o/ �vork u�ill be cornplefed <br />�vhetherspecdieAherein ornot. 1"he granfin� ola pernul does nof presum� fo give authonty fo <br />violafe or cancel Ihe provisions oI any other sfafe or local law mgulafing construchon or fhe <br />peAormance oI cons6uclion. Thaf 1 am aufhorized by (he o�vner o( this property fo pedomi the <br />worA /or which application is maAe and I compiy with fhe State Contractors La�v 18.2i RCW anA <br />296200 WAC. � <br />� <br />FEE <br />_ �p <br />�o� G�� � <br />lio <br />