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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 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />�l5 11�111 `-1 `-=� <br />PROJECT ADDRESS <br />� �, <br />l.�'C', B U�`�_J 1_= <br />Owner <br />�n <br />i�'.5 u, CcF.1,IS5 /� ti' <br />Mail Atldress <br />`-F�Tft� � `l�'' 3�� cz.� )=� %8vo <br />(;;ry State2ip Phone <br />���0 5�.,�►�Ci 61S tl�"t"N sl� `�c #u �.U�t� v,�A ���s' �qzs)-��'�-►s�•, <br />Tenant Mail Address City State�Zip Phone <br />Te���, ��S �iuH 5`l S� �D ��`��t'� v,;/� 2��„y' �y'��)���-ls��c, <br />�� ----- <br />Electncal CaNnctor h!ml AOdress City SlafeiZip Phone <br />Stale Lir.ense <br />1:t��"I�AAn�. •.L / � <br />Proposed Use o( Buildinc� <br />�^h c*- <br />�� .� l' <br />Contrect Price af Work <br />� _ �f10 i �. Vi A1�1 <br />Contact Person (Plan Review) <br />DescriptionofWorkloBeDone�. ��J��L/'1L ���� �� �'1�1", ��f�1tT�v°�5 �n�. <br />�� Jo���_�-nrT �t�fjrs c�- ���.�r� �.x _�>>csN — <br />NOTE'. WIRING IN NON-DWELLINGS IS REOUIRED TO <br />BE IN RACEWAYS, MC OR �C CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS J705 <br />I hrn�b�� crrtdy fhaf I have �end nnd exarnmed fhis npPhcaOn�i nnd know �he same fo be true end <br />carect. All piows�ons o� laws antl orNnr+nces governmg flvs type ol worR wdl be compleled <br />whethe� specdied herein oi nat. The gran6ng ol a pernuf does nof piesume ta yne authonty to <br />v�olatr or cancel fhe provisions ol nny other sfafe or local inw reguleting r.ocst�ucfion or fhe <br />perlorrnancr, al conshucticn Thet 1 am aufhonzed by fhe owne� o� this property fo perlorm fhe <br />work lor which application is made nnA I cornply wdh fhe Sfafe ConVacfors Law 782� RCW and <br />255.200 WAC. <br />FEE <br />-t �1c''s -.3 � <br />�� <br />� <br />� <br />