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r <br />ELECTRICAL PERMIT APPLICATION <br />CITX OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, VJA 98201 <br />425-257-8810 - FAX 425-'L57-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�� �� � ? <br />�► -� �7T" Av �. S� <br />PROJECT ADDRESS <br />Owner <br />Mail Address <br />V Y <br />Clly <br />Tenant ,�n�_ M ' Ad City <br />`�-}-lsst fJ �'L��---P2"�` <br />�-i�flSS��'l 5 3'�� t' • � . �� <br />Conlraclor Mail Address <br />ucense rvumber <br />� <br />�'2�-��= � C � <br />Praposed Usc of Building <br />S �� � <br />7 �� <br />Slate2ip <br />Phone <br />State2ip ���hone <br />� �� 3�y z��,, <br />City Slate2ip Phone <br />L�7 <br />� C� �Go -- <br />Contract Price of Work <br />Contact Person (Plan Review) <br />Descriplion of Work lo �e Done: �1. /" �JIY} �--1-- �j ^ ��� � c�-t �—��'`TS <br />��-S� s � �, Qfl2►S t-4 �F"�i c� <br />NOT[: WIRING IN NON-DWELLINGS IS REG�UIRED TO <br />BE IN RACEWAYS, MC OR AC CABL[. <br />CITY OF EV[RETT LOCAL SALES TAX CODE IS 3105 <br />l hereby certi/y that I have read an <br />correcL All provisions olla�vs and <br />�vhether specified herein or noL Ti <br />violate or cancel fhe provisions ol� <br />pedormanceo/construclion. Timt <br />work !or which applicalion is made <br />296.200 WAC. i; , <br />this application and kno�v fhe same fo bo true and <br />governing flus type o/ wor;c will6e complefed <br />>/ a pernut does nof presumo to give authonty to <br />ite or local law regulating constructien or fhe <br />'zed by the owner of thrs property to pe�fonn fhe <br />y wifh the State Contractors Law 18.27 RCW and <br />FEE <br />EILC��I � 1�1 ;,? <br />