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� <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 Ahl TO 4 PM <br />S i �i � JGurJq 11J4 <br />PROJECT ADDRESS <br />t_vCfLET� <br />42S-3V3 -' <br />[3i�L 5N�lOEfL S14(r • `,�c�un /�. ��iEQChT i,� A `�8L6'S <br />O�mer Mail Address Ciry Slate2ip Phone <br />'(jlll SNYnE2 SI�I� 5o„�n A�E �VEttE'ir l,,A �g�2o3 4"ZS•3N3-' <br />Tenanl Mail Address City Slato/Zip Phono <br />HEAn �s� , ccxc � uG <br />Electrical Conlreclor Mail Address <br />L 5 i-1'T L 5-��1 `13o RK <br />Stato License Number <br />IIES\DL�.10E <br />Proposed Use ol9uiiding <br />A11J ST. <br />City <br />SIatMZi � <br />Contract Price o( Work <br />5 �CVE �(ZAZiE12 <br />Contact Person (Plan Review) <br />Ex�S7�ac, <br />DescriplionofWorkUOeDone: CONVE2T � z`�U�/ 'TO 1'tGV �C FEEO IUEi..S GF15 <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 />1 hereGy certi(y Ihal l l�ave read and examined this applicafion and h::a�v fho sarne fo be (ruo and <br />correct All provisions o! /aws and ordinances govenung (his type o! work will bo complefed <br />�vhethr,r specdicd hercin or noL The yranting ol n pem�rt does nof �resumo t� give authonry to <br />violafe or ce�ncel the �rovisions olany other state or local law regulating consWclion or the <br />pe�lonnance o/ cons�n�ction. That 1 am aufho�ized b}� fhe owner o/ fhis property to peAomi fhe <br />wo�k !or whir.h applicalion is made and 1 cornply �vilh fhe Stafe Confractors Law 1827 RC W and <br />29G.200 LNAC. <br />� �-�, 7'Z9- lo <br />FEE <br />lo°��-'�� <br />Phone <br />