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ELECTRICAL PERMIT APPLIC��TION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everethva.org <br />APP�ICATIONS ARE ACCEP'i ED FROM 8 AM TO 4 PM <br />�iL`� s�-� s� <br />PROJECT ADDRESS <br />�,Y� fj�r5e/ ! S Z'i Sri ,� S� <br />Owner �fail P.ddiess <br />Tenan� <br />//`r7i�G dtvNt� <br />Eleclrical Coniractor <br />rAaJ ndArese: <br />Stale License Nmnber <br />�/�i.h/ /7G/bG�L/ <br />Propesed Use of (3uilJin� <br />Description of Work to �e Done: �tor� C�r�v� fJ� ����` <br />NOTE: WIRING IN NON-DW[LLINGS IS RGQUIRED TO <br />f3C- IN RACEWAYS, �1C OR AC CABLE. <br />6/c 5 kz o/ <br />S�ale2ip <br />5I':Ie'Lii� <br />s�aie2�n <br />Conlraci Price o( V�brk <br />yLs =LS3 •SO/$ <br />r'nonc <br />Conl,+ct Person (Plan Revi�w) <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hemby ceriify Ihat 1 have read and examinod this applicafion nnd knon- Ihe same to be frue and <br />conecL All provisions o/ laws and ord6�ances goveming (his fype o/ nork �vill be compleled <br />whether speci6ed herein or noL The granfing ol a pennd does notl�resume to give aufhorif}� fo <br />violate or cancel fhe provisiuns o( an}� other state or locnl la�� re9u atinc� consfn�cfion or the <br />perfonnance o/ consfn�cfion. That 1 arn aufhorized Uy fbe owner o( fhis property to perfomi Ihe <br />work (or u�hich application is rnaAe mid 1 compl}� �rifh the Slatr, ConVac(ors Law 7827 RCbV and <br />296.200 11'A C. <br />� i: <br />Fhen� <br />I�none <br />FEE <br />C c.- <br />�(��1.� � `� � <br />