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ELECTRICAL PERMIT i4PPLICATiON <br />C�TY OF EVERE i T PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 Cf,_�/` �Z <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />e;z��(-�S � <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />2j'SoZ 56 �h S-� Su'' ��;L�t�fi'� w f� ��20 5 <br />PROJECT ADDRESS <br />c�r�5 r.�nn,n� 3��z 56`''` St 5�1 Fv���e-(�- <br />Owner / Mail Address Cily <br />Sq h^{_ / <br />Tenant <br />Mail Address <br />City <br />jac�� o�l�n� 1`�e_c�-,-;� I�iZo'a z�+l 0: SG 6�-II...�\� <br />Electrical Contractor Mail Address Ciry <br />_,nc�eorSw�,'� <br />State License Number <br />Proposed Use a( Building <br />�,n��$z�> (3��)gz��-�°�3 <br />State2ip <br />Stale/Zip <br />Plione <br />Phone <br />l�A1�4�12 Ck2S)3°ti-�k2`j <br />Stale/Zip Phone <br />�`� CjOp <br />L <br />Contract Price of Work <br />Contacl Person (Plan Review) <br />�;s;�. �,� p��. r�,, � k.���., ��,�,o� ( <br />Descrip�ion of Work to De Done: _ �_ — <br />ou11z-1� �e�c��fr_s. I�-��T— <br />NOTE: WIRING IN NON-DWrLLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certily that 1 have read and exarnined this application and know the same to be frue and <br />correcL All provisions of laws and or'dinances gooeming this type o( work wi/l be completed <br />�vhe(her speafied herein or noL The granfing of a permit dues not �resume !o give authonty to <br />viol:te or cancel tho provisions_o/ any cther state or local law regu/atir.g construcfion or the <br />...,. ..,..r,..,., ,�.� <br />�II�Pr � 1 Zu IZ <br />FEE <br />•� �'� <br />��Z�J�-�S l <br />