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ELECTRICAL PERMIT �PPLICATION <br />��5� ti <br />PROJECT ADDRESS <br />Owner <br />�����I.JA <br />Tenant <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 <br />� <br />��� �c;��: ��_,., � <br />Mall Address <br />Mail Address <br />City <br />Gly <br />Stale2ip <br />Slate2ip <br />Phone <br />Phonc <br />� Z�a, <br />"_-�vli ��rZ-� �� �x �L Ac-1�,��F�.� vJAc`��r zz3 �>� _, ->>> <br />Electrical Contractor Mail Address City State2ip Phone <br />� ^�/) � � � ;/1� �-- � � �i �� / <br />J <br />Ie l.icense Numbcr <br />��/ �vU t <br />Contract Price of Work <br />� <br />j\i:U:; 1MLv?YT/t <br />Propused Use oi �uilding Contacl Person (Plan Review) <br />DescriptionofWorkioDeDone: �-�S"��1 ` �`�"��C 1�S -� �`��`�-�t� , �'U�(�C� <br />,.� \ C'. c�� r � [�L� \ L�O NVIG G � �1 6iti� - \ �-' � ��-�L•� �.��1� l�J �1ni1 <br />./stn� <br />NOT[: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR A� CABLE. <br />CITY OF EVERETT LOCAL SALES T!J( CObE IS 3105 <br />1 hereby certi(y that 1 have read and examined ihis application end kncw the same fo be true and <br />corr�ct All provisfons ollau�s and ordinances governrng fhis type ol �rork wilf be compieted <br />whefher speci6ed herein or not The granling o/ a pernuf does notl�resume to gire authonty to <br />��iolate or cance/ the provisions o/any other state orlocal la�r regu ating construcfion or fhe <br />peAvminnco o( construcfion. Thaf 1 am aufhonzed by fhe o�vner o/ fhis property fo pe�/omt the <br />�rak lor �vhich applicafion !s rnode and 1 comply with fhe Sfafe Confrnc(ors Law 18.27 RCW ond <br />29G.200 WAC. <br />— __ / � <br />I1 �z� ��Y <br />FEE <br />CCjg i I - l33 <br />s <br />