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EL�CTRICAL f'ERMIT APPLICATIO� <br />�ITY OF EVERETT PERMiT SERVICES <br />3200 CEDAR STREET, EVERETI', WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� s� 2 � �� /h:r- ��` - ��� ��z�,� <br />PROJECT ADDRESS <br />_)/5.�✓ C.�/�F ti-f <br />Owner <br />Tenant <br />Mail Address <br />Mail Address <br />City <br />Cily <br />State/Zip <br />Slate/Zip <br />!D -i2 �i� <br />C�o�a-063 <br />Phone <br />Phone <br />C�/Ci?`S �l<<�i'�c LCc. 2<�i �'fvA�c�a�Z�� �Aka';icuw,;5 W� 9�P7s�' y1S�iY3v�2 <br />EleCtriCal Conlraclor Mail Address Cily Slale/Zip Phone <br />G'l��'�5 �-� q��2;JG <br />State License Number <br />Proposed Use of Building <br />Descriplion of Work lo De Done: <br />%L�,^..��7c�7../.Z� �L'wL�i'— <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Contract Price of Worlc <br />Conlact Person (Plan Review) <br />°'f �c' ��//�17LS�C)L.c JV/J LG"'� I <br />1 hereby certi(y that 1 have read and exarnined this application and kno�v fhe sarne to bo true and <br />currtcL All provisions nf la�vs and ordinances governing fhis type of u�ork �vill be completed <br />ivhefher specified herein or not The granfin� of a pernut does nof presume to c�ive authonty to <br />violafe or cancel fhe provisions o(an}� otAer stafe or!ocal la�v regu/ating consfruction or(he <br />pedormance olconstnicfion. That I am authorized by the o�rner o(this property to peAonn fhe <br />wcrk lor�vhich applicafion is made and I comply u�ifh the Sfate Confracfors La�v 18.2i F�CW and <br />296.200 WAC. <br />?G-, �;'��` l `7�� <br />� o � � <br />FEE <br />