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ELECTRICAL PERMIT APPLICATION <br />PROJECT ADDRESS <br />Owner <br />Tenanl <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVC-RETT, WA 38201 <br />425-257-8810 - FAX 425-257-8857 — www.evereltwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�{ �Jlc�il w� ��c,�tij <br />� a isK2i a��'',.1v�� ,i�, <br />�Mail Addmss Cily <br />M19ail Address <br />City <br />(�!a— i �s��e'S <br />Stale/Zip <br />Statc2ip <br />/a., ab-�> <br />�07�o--i5� <br />1(/ <br />.� <br />; � �,25 s-� vz <br />Phone <br />Phone <br />(� `�L.t1l�'Lt_ v' j / � . �r C ' LiT �cyt—�.,1. c-�, ni{j i ,i.t <br />Eleclrical Contractor �dail Address City State2ip Phone <br />� �,1 � '7�' r_ <br />Sl'ale License Number <br />`-�1 1r `� <br />Proposed Use o( Buildin9 <br />Contracl Price of Work <br />��.�i l (��IJ �I M �'l_! ___ <br />Conlact Person (P�an Review) - <br />Description of Work lo Be Done: F�-/{� � /�L�l� 1 ��he i-r '71 .., � r ���i�u�� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hmeby cerfily that 1 have read and examined fhis appi <br />conccL All pruvisions olla�vs and ordinances governu�. <br />u�hether specified herein or noL The c�ranfing ola pern <br />violafe or cancel fhe provisions o/ any other sfate or loc <br />peAermance o! construcfion. That . m nulhorized by t <br />�rorF lor �vhich �pplication is mad and I comply �vifh fh <br />29�.200 bVAC. ' � _' �, <br />'_ /_� � �� ° •�..r��--'�� �-.- �7 <br />�•—if�'A''??='� . __..y �t_':.._i. �-_. - <br />�nawro <br />ition and knou- Ihe same lo be true and <br />'his t}�pe o/ work �ti�ill be cempleted <br />does not preswne to give authorit}� lo <br />Imv regulafing construcfwn or fhc <br />owner o( this property fo pedorm the <br />Sfate Con6acfors Law 78.27 RCW and <br />FEE <br />� C)-1 10 - V'� � <br />