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ELECTRICAL PERMIT APPLlCATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 32.00 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-f3t357 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> 24'%5 5,�-rl' ,� <br /> PROJECTADDRESS n_— ��� <br /> � �� �, � �,��, �n {, � �- <br /> 15l"' � � <br /> i' t.-/ � � �C-� y�/� %���iG� �`�—�' i <br /> ���ft���f� S�ly � 3���i S� �u�?r,ut A� ?S4�'/�° 6�-'<�6�Zy <br /> Owner Mait Address City State/Zip Phone <br /> F��erz� 2y'2;� 3,�i��� � . t�,�,,e4i wl�(�'ol f'2�=3o3-9zoo <br /> Tenant Mail Address Ciry Slate/Zip Phont <br /> �� ' ei�-��I' wr. 5�:� y z c� ?��.g6Cl� <br /> I-IK�'I'Jl7i-'ffoniieA • ��x. (-�,s��r Re{ , 'I �? u <br /> Electrical Conlractor Mail Address City State/Zip Phone <br /> I <br /> T1(�c-I 1 yR'�'211-{� � ��` i <br /> Stale License Number Contract Price of Work <br /> �• K'w� L . c��s <br /> r� �)cccg�n�y c,:���{%<1 ' <br /> Proposed Use of Building� Contact Person (Plan Review) <br /> � <br /> �escription of Wark to Be Done: � S 4, ��Uf1�t fiLNxh� (YSI f F4 rJ � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> ��� - <br /> CITY OF EVERETT LOCAL SALES TAX CO�E IS 3105 <br /> 1 hereby ceRify that I have read and examined this applicafion and know the same fo be true and <br /> correct. All provisions o/laws and ordinances goveming this type o(work will be completed <br /> wnether specilied herein cr not The grenting of a permit dees not presume to give au[hority to <br /> violate or cancel the provisions ol any other state or Iecal law regulating construction or the <br /> perlormance ol construc6on. That 1 am authonzed by fhe owner of this propeRy to peAorm the <br /> work�or which application is made and I comply wdh (he State Contrectors Law 18.27 RCW and <br /> 296.200 WAC. �� <br /> / �_ : <br /> , � <br /> , ��''.- I,:�'ta�r, _ 2I <br /> Ignatcre Date �� � <br /> /� � - ' J <br /> Li <br />