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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 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />'3�� �=��:- �til�. ��iv�. <br />PROJECT ADDRESS <br />T�-i7_�(ioto7- L <br />Owner <br />�k �i.��' <br />Tenant <br />a� L Lc,tc il ��.a ��" « � <br />s� �,�� <br />Mail Address <br />Mail Address <br />City <br />City <br />State/Zip <br />State/Zip <br />Phone <br />Phone <br />��v��� Cu l� C���,,.��.,,,,,,�-��s S'72`I /l Y�' SJ Sc' S�'ro%6,.+,r?>" G�l-f J6'29G vr�Ysi ss- <br />Elee..rical CoMraclor Mail Address City State.2ip Phone <br />ri �I57 C 1 DO�) i�i'� <br />State License Number <br />Proposed Use of Building <br />Description of Work to Be Done: <br />..i i - r,�..� ; <br />NOTE: WIRING IN NON-CWELLINGS IS REQUIRED TO <br />BE IN R,4CEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br />Contract Price of Work <br />Contact Person (Plan Review) <br />'l�� c� i C �= � irf--i-c-i <br />I hernby certity that 1 have read and examined fhi� application and know the same fo be tn.� � and <br />correct. All provisrons ot /aws and ordinances gover�ing this type ol work �wll be comp/eted <br />�vhether specil�ed herein or not ihe granting o/a permrt does noi presume to give authonty ro <br />wolate or cancel fhe provisions o(any other state or local la�v regulating c�nstroction or the <br />performance ol cons(ruction. That / arn authonzed by the owner of ihis property to peAonn the <br />werk lor �vhich application is made and I c�mply with the Sfate Contractors Law 19.27 RCW and <br />296.200 WAC. <br />� <br />y� <br />F�E <br />� CSG� -G�3 <br />