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PROJECT ADDRESS <br />ELECTRIGAL PERMIT APi'LICATION <br />CITY OF EVEREiT PERMIT SERV{CES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everetlwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />l�','" �i,r �-J <br />y -a3-�7 <br />C o�o U-/6 y <br />Lec�c-� uznti'cy �Y-L- .1T{��NS (�f� 4zS-33y c <br />Owner Mail Address City Slale/Zip Phone <br />Tenant <br />r�,u,�e-� � <br />Electrical Conlraclor <br />M17ail Address <br />�c /NZ�i �1� a <br />Mail Address <br />tflhv� tt� � l 7�j B n�1 <br />Slate License Number <br />j,�<�� -��ii�y l����z���i4 <br />Proposed Use of Building <br />Descriplion of Work to f3e Done: <br />N <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CA�LE. <br />CITY OF EVERETT LOCAL SALES 7AX CODE IS 3105 <br />City, <br />City <br />�� <br />Sta�e/Zip <br />Phene <br />yzS 377 <br />Stale/Zip Phone <br />�. ��L��. `., <br />ConVact Price of Work <br />A��-� y���,� t� <br />Conlact Person (Plan Review) <br />Lc�i�C'r [ <br />1 hereby certi(y Ihat i have read and examined this applicalion and kno�v the sarne fo be true ar�d <br />correct. All provisions ollaws and ordinances govemmg this typo ol work will be completed <br />whetherspecified herern ornot. The granfing o/a permd does nof presume tu give authonty to <br />violafe or cancel fhe provisions of any olher state or local la�v regulating cons(ruction or the <br />perlonnance o/ consfruction. That 1 am authonzed b�� fhe o�rner oI this property to peAomi fhe <br />work (or which applicafion is made and 1 compty �rith the State Confrac(ors La�v 18.27 RCW and <br />29G200 WAC. <br />� �^ <br />FEE � <br />1: L�7C'�- 1 � �t <br />