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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 — wvdw.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />`,2� 5� a #�2 � zo1 � 6>� S<. , r_vz�e�'�'� �J�� �l� Lo \ <br />PRAJECT ADDRESS <br />3� <br />I�- � 3101 Ce �1�� S-t. ��°,�- Wi�9 ��zo� �,��Co <br />1-qc� � i<'- <br />Owner Mail AAdress City Slate/Zip Phone <br />'-i r <br />Tenanl <br />� U ti' r L'`'�' <br />Mail Address Cily <br />W �i �SZ� � <br />Slate2ip Phone <br />T . <br />�1v e vv�-��S`��� <br />Elecirical Conlractor Mail Addmss City Stale/Zip Phone <br />State �icense Number Conhacl Price of Work <br />�0 f �re �Pa,�,l��r✓ �L��. ��e� ���� Z <br />Propoo� d Use of �uilding Conlact Person (Plan Review) <br />1 . 1 j� <br />Descrip�ir,nofWorhloBeDone: �hS-�•..\\ <�pL�nC� � �b��Q�f _l� \��Ve S��"������'� ��^^ _ <br />�.: . _ -- � <br />�v'r�L��i ���r�� Y��a,���`.���1 <br />� <br />���,c�r ��5�� <br />IJOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETf LOC.QL SALES TAX CODE IS 3105 <br />•���ti . �� <br />1 hereby certi(y fhat I have read and exarnined this application and know Gie same to be true and <br />correct. All provisions ol laws and ordinances govemin� tfus type oI a•ork will be completed <br />�vhether speci6ed herein or noL The �ranfing ol a permd does nof resimie fo give aulhonty fo <br />violate or cancel the provisions o(an}� ofher stafe orlocal law reguPfing construction or the <br />pe.�forrnance otconsfruction. That 1 arn authonzed by fhe o�ti�ner o/this property to perforrn the <br />�vork.l Nhich applicalion is rnade and 1 comply with tlie State Contractors Law 18.27 RCW and <br />2flB20� WAC. <br />� � C � �, ,, , <br />J/��/� <br />FEE <br />�d�o4-or3 <br />