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ELECTRICAL PERMIT APpLICATION <br />CITY OF EVERETT PERMIT S��VICE$ <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />4`��i7 �1�' A,� �� <br />PROJECT ADDRESS <br />(7� ���� p��ver LLC. SL131,� Be! �Z..�� R. ,I �!- �cx� ,�.;I„��„i ,�' � iti�-`�7 <br />Owner Mail Address Cily Slate/Zip Phone <br />[' <br />�'?n; �-�c Q�cek<<Ve Y.n . 4tc1! ��`- ,�Q�< <� �ut'�ef}- i.�� � 1(.'Z� <br />Tenant Mail Address Cily Slale2ip Phone <br />Electrical <br />Mail Address <br />(�,F � F�F FI-1 �i'is � " <br />State License Number <br />l.'�i-{ �' (, <br />Proposed Use af Building <br />Ciry <br />Description of Work to Be Done: �f n�n � � � �� �"�e"Y��'1C S TU'"f� <br />NOTE: WIRING IN PION-GWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 9105 <br />v.�.44'o%.F� kZ5�4H1-3<� <br />Slate/Zip Phone <br />,�{ 2 cC�. CG <br />Contract Price of Work <br />IJLII:t EUGIItS <br />Contact Person (Plan Review) <br />1 hereby certily thaf 1 have read and ezamined Ihis application and know fhe same fo be Irue and <br />correcf. All pro�•�sions o( laws and ordinances govemn�g this type ol work will be complefed <br />whefher speci/ied herein or not The qranfing ol a permd does not presuma lo give authonty ro <br />vio/afe or cancel fhe pmvisions of any ofher sfate crincal law regulafing construction or fhe <br />per(ormance o/consfrucfion. Thaf I am aufbonzed by Ihe owner of this property to porform fhe <br />work lor which applicafion is made and I comply wifh fhe Sfate Conhactors Law 18.27 RCW and <br />296.200 WAC. <br />C��`' <br />, � UJ <br />FEE <br />J��� <br />