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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 -34 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org C// V/`V0Z <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� ") ? ` i '13r°t 4i• 5 � � U-e..it,�� "J A �1 `6Zo3 <br />PROJECT ADDRESS <br />Nc; •ln n 1"11r\ `l3" t ��� �� t\j-g.4JV. `AiA rt`6103 (12.5.S44--7`dF,S <br />Owner Mail Address Clty State/Zip Phone <br />Tenant Mall Address City Slats2lp Phone <br />IP�AIF_/Urnrlfall-l.1P _WA ctrGZ_'10 (4t'S]'546•yL17j <br />Electrical Contractor Mall Address City <br />State/Zip Phone <br />�y�T t.n - ctolLW HOD co <br />Stale License Number Contract Price of Work <br />Proposed use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: �j'1 �� ` r1 r-i wv_�M <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances goveming this type of work will be completed <br />whether specified herein or not. The granting of a perm does not wesume to give authority to <br />vlolafe or cancel the pprovisions of any otter state or local law regul,afing construction or the Q a <br />work which application Is made and I complyawiith the State ContrecformspLaw 1B perform <br />end I' b l O <br />296.200 WAC. <br />Signature _ Date <br />