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Oeo 17 04 OB:25a Wm. Trae BroWn <br />� <br />360-�35-9�89 p.2 <br />1 <br />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 />APPLICATIONS ARE ACCEPTED FROM ! AM TO 4 PM - DEBIT 8 CREDR CARDS ARE NOT ACCEPTED <br />qll - lo�iTM p� s� <br />PROJECT ADDRE85 <br />t�n►c, �f►i ra�fi^° P� s F Gvc�e+F W� 9�� <br />Ownx Mau naene� cty su�.Zp <br />Tenant <br />Eleclncal Conlrectar <br />�V J�L/4E2 `f72K�j <br />State License Number <br />Proposed Uee of BuildiM� <br />DescrlpUon of Wo�k to Be Dona: <br />AAiil Addrsfe <br />Mall Addreee <br />NOTE: WIRING IN NON-DWELLINGS IS REOUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALE9 TAIf COOE IS 310� <br />CNy <br />GN <br />SMbZp <br />su�a2'p <br />'� 1oo.oD <br />Contract Price af W ork <br />Phona <br />PAona <br />�J� <br />7YAG $hwn �5-q23-59410 <br />Contacl Person (Plen Revlew) <br />I hereby certNy fhef I heve reed and examrned tnis epplicalion end know 1he same to De frue end <br />eo�red. Alf provisions ol iews end o�dlnences govaming fhrs type o/ work wlll De complefed <br />whefher epecified herem ar not The granlmp ol e permrt does not presume fo plve eufhonty to <br />nolefe or cencef the proNslons ol eny other sfefe or locel law mguletirrp caosfrucUon or fha <br />peAormance ol constn�cfion. 7het I em aufhcnred by fhe owner oll6ra properry to peAorm the <br />work /or which applicahon is mede end I comply wrth the Stafe Confrectors Law f 8.27 RCW and <br />296 200 WAC. <br />il�w. ( 1� gl.�ti n ►Z' Itt'b`� <br />-�iqnNure • <br />�a-iw <br />FEE <br />