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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.evereltwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />' I' )Sill s.r bka 5u rt5 -"cNi <br />PROJECT ADDRESS <br />Owner Mail Address City State/Zip <br />Phone <br />A— <br />�&cT /1ii:OSPAc-i; 'iAM'S. %S Sr'15: /�'�24-�iS <br />Tenant Mall Address City Slale/Zlp <br />Phone <br />&WLiz.yUL r 11" Asc Mi. ACLInI<<TOK) WA 96223 'L')tS Z44 14H5' <br />Electrical Contractor Mail Address City Stale2lp <br />Phone <br />" <br />©malt.22 i�sg3l r,c. 2Jo u 2. <br />_ <br />Stale License Number Contract Price of Work <br />��F(' t�tt.�4sA2o <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: F 4 rL1, AL.A mr� -r / i S/ ^' YxS 5� AvO,Ar <br />yrsvAt <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />�UZso <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that I have read end examined this application and know the same to be true and <br />correct. All provisions oflaws and ordinances governing this type of work will be completed <br />or th ty to <br />angranting <br />violateeor cancel erevisions other stateaor to ral <br />the revisionsof law regulaf/ng construction <br />performance o/construction. That I am authorized by the owner of fhls properly to perform the <br />forwldah (orsl:aw^18.27RGW-end- <br />—work. pplkrofionlismadeandIcomplywithfhe-SlefeGontm <br />298.200 WA <br />l ////��% /� <br />_ <br />,8 9nature DaW <br />