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( <br />ELECTRICAL PERMIT APPI�ICATION <br />CITY OF EVERETT PERMIT SERVI�ES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www,everettwa.org <br />PROJECT ADDRESS <br />Tenant <br />�G�/O/�C C/ <br />Eleclrical Conlraclor <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />Mail Address <br />hlail Address <br />- S. -�-7` ,S? � <br />c��}; <br />i^i C ,. , Qf <br />L1ail Address <br />oli��'u-�� z0 8'gT� <br />Stale ! iccnsc Num�er <br />N � if 6�' l -c-ac�C <br />Propo.,ed Use o! Bwldin� <br />Descriplion of Work lo Oe Done: <br />7. <br />1 A 1 <br />��, <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN FiACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Clly <br />S`� S- �S� - 9 y7� <br />5(ate2ip Phone <br />Slale/Zip <br />Phone <br />79�' � �i�!! �//�, g�'c7�f/- 0.2.��5" <br />Ci(y State2ip Phone <br />`�.i O d �`6GCz <br />Con/"�tr�acl Price of Work <br />C�/"/le.G� <br />a��(�r .- Z Zp' j ��, <br />Contact Person (Plan Review) <br />1 hereby certily (haf 1 have read and exantined this applicafion and kno�v the sarne to be frue and <br />correcL All provisions o//aws and ordinances govemmg tliis type o/work will be comple(ed <br />whetl�er spec�l�ed h�prain or noL The granting o/ s penmt does nofp resume to give authonty to <br />p� or ance�o co/nstru t�on��Thatlam�a�uthorizedbythe/owne o%ffis�Cro enyfope��m�the <br />work /or which applicafion is made and 1 canply with the Sfate Confracfors Law 18.27 RCW end <br />296.200 INAC. <br />%tJ.��; �'Gl�,��r�-- �rfzG�d� <br />Siynafure „_,_ _ <br />FEE <br />Y� � �-O:r�/"io. <br />