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ELECTnICAL PERMIT APPLiCATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 C[DAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX �125-257-8857 — www,everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />,y�.� ti r� r,l �, r- �- -, <br />�� � ����- �ti �1-1 �J ��� z c� r <br />PROJECTADDRESS <br />Sc:,,: o. l� o � �S �,�� <br />(hvner <br />Tenant <br />�(���..IFi� 1C49�Yti•�- <br />�/ � <br />1]L�iICti� � ��,1��CM [(� <br />Eledncal Contrador <br />��'�/i � � ' ��. S r <br />Mail Address <br />Mail Address <br />Mail Adtlress <br />i�G��� � (.l � 1Z'3T9 <br />State License Number <br />! :.�-LI �k�.l <br />Proposed Use o( Building <br />City <br />City <br />City <br />State2ip <br />Stale/Zip <br />State2ip <br />"- �3C1��,— <br />Contrad price of Work <br />(:,� �� C�s� � � <br />Contad Person (Plan Review) <br />Descnption of Work to Be Done: 1.��.,���,ti� ti .��, �(�,.r�� �Ui� ,� �- A��� � I <br />I .. <br />L N <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERE7T LOCAL SqLES TAX CODE IS 3106 <br />/ hereGy r,ertity (haf I have read and examinod (his applicafion and know the same lo be true and <br />correct. All provisiorrs ollaws anri �Rlinances qovemrng th�s type o( work will6e completod <br />whe�her speci�ed heroin or noL ;.3 granting ola permd does r,ot presume (o give aufhonty� to <br />violale or cancol fhe provisions of any ofho� sta(e or /ocal law regulaling consWcfion or the <br />work t r wh ch e plisahon�s ade� and I comply wifh (he State Qonf h-actors� wY18.��RCW and <br />296.7.00 WAC. <br />,�� <br />—� <br />.i Signawre — �'Z � UC � <br />Uate <br />FEE <br />��I"L- 11l <br />) J���-tJ Si% <br />Phone <br />Phone <br />��/ -(i j ' 7 <br />Phone <br />�• _ _ _—_ — — -- _ — _ <br />