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ELECTRICAL PERMIT APPLiCATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />S_� L�_ `-I) <br />PROJECT ADDRESS <br />l�� �(f—/;iUC�= <br />Owner <br />Tenanl <br />/�f ���IN <br />ElecUical CoNracl <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�!� ti�,� <br />CJl� a �_ <br />Mail Address <br />Mail Address <br />: C. c. C. 1 ��� � <br />Mail Address <br />�1� i. i� l l�j /� L �;; � ti�; : <br />Stale License Number <br />L�}1 ' 77 <br />---f / = /"L <br />Proposed Use of Building <br />Descriplion of Work la Be Done: . _/lf � �1,� �5 �— ��— <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />City <br />City <br />Cily <br />State2ip <br />S�atelZip <br />State/Zip <br />Contracl Price of Work <br />Conlacl Person (PI2n Review) <br />��-� .� ��/l.'l.f"; <br />CITY OF EVERETT LOCAL SALES TFU( CODE IS 3105 <br />I he�eby certily Ihat 1 have read and examined fhis applicafion and know the same to be true and <br />c�rrect. All provisions ollaws and ordinances governmg fhis type oI �vork will be comp/efed <br />whefher speci6ed herein or noL The g�.�nfing o(a per;nd does not resurne fo give aufhority fo <br />violate oi cancel the provisions olany other stafe or local la�v reguPfing construclion or the <br />perlornrence oI cons(ruchon. That 1 am au(horized by the o�vner o/ Il�is property fo perlonn the <br />work lo� which applicafion is made and I compl}� wifb the Sfafe Confiacfors Law 18.27 RCW and <br />296.200 WAC. <br />// <br />'�7 /��ln:'� : %/�_ �/-/S�- L'� <br />fEE <br />� -� L�\. <br />/� `\ - <br />l <br />U'�./_ ��� <br />7 <br />. <br />Phone <br />Phone <br />Phone <br />