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ELECTRICAL PERMIT AFPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 9P,201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�.)-��r <br />rl. c <br />�,-�'�-��-� - �o � f- � �ver�• (r-�Ja i �,'>� <br />, <br />PROJECT ADDRESS <br />/ � c/��x-�L.�� (s�l�r' (c"�.c �'U• �jic7.< l�ia'��7/� ��o Ii:..n,buS (�f-f �/�51l�' _ <br />Owne� � �dadAddress City State2ip ���y_�yJ_ Phone <br />��775 <br />Tenanl <br />Mail Address <br />��r .,le�{.��, r.,� i!f'. <br />Con�ratlor � MailAddress <br />Y+'! /1 Tc� r E ��-�, � M N <br />Slate License Number <br />C��f�ta�� �'e(l 5�-�c <br />Proposed Use of Building <br />Cily <br />�y.1rJ/�r✓G,U.• <br />Cily <br />State/Zip Phnne <br />akt�„��ir�_ vas-�rs��a�,-�� <br />��71 Slate/Zip Pnone <br />� /7, c�y� <br />Contrect Price ct Work <br />i„��/�vr�-,r f < <br />Contact Person (�lan Review) <br />DescriptioaofWorktoBeD.ne�.( � i �J�W aJ�%�.�>i� ���'•v"`=. l.i0�1�{C ✓�t <br />�%> :���3,w� iu��„et c�,���., E <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 />I hereby certi/y fhat I have �ead and axamined this applicafion and know the same to be true and <br />correcL All provisions ol laws and ordinances governing fhis type of work will be completed <br />whefher speci(ed herein or nof. The granfing o/ a peimd does not resume fo give aufhonty fo <br />v�o/afe or cancel the provisions olany other sfate or local law reguPting construclion or the <br />peAonnance o/ conshuction. Thaf 1 am authonzed by fhe o�vner ol lhis property to pedorm the <br />�vork for which application is maduand I comply with lhe State Confractors Law 1827 RC W and <br />296200 WAC. <br />.��(��� //V/� J <br />FEE <br />��%� /J� <br />. ���� -//� <br />�� <br />