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ELECTRICAL PERMIT APPLI�ATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 96201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �Z � �,_�� <br />y� z�v r; -���� ���� y <br />PROJECT ADDRESS <br />Owner <br />Mail Address <br />,� <br />City <br />��Z � ,Bt/��Li.fi� �L <br />� 0 g'1 Z-0� <br />Slale/Zip `' zJ - Z.S `l y� � �7 <br />Y <br />� <br />�v�✓..�� <br />Tenanl Mail Address Cit � State2i s -{� Ho� <br />Y p � —LS7 —'gf 71' <br />���'� '7�c (�H v�v5«.1 cZr.</C� i� /3ot� 2!� 6(a6 ��p �z.. �w�� GL� <br />[ledrical Contractor Mail Address City / State2ip ��rya �' <br />�! 2 E 77 � R z3 L�- ���l�I���.� .�i`��uo o c. .. <br />Slale License Number Contract Price of Work <br />/?�� f.e. / <br />Proposed Use of Building <br />Description o( Work to 8o bone: <br />�G �2e �/t cs-o <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />G%'�-�i� T R t�l.�C.�% <br />Contad Person (Plan Revicw) <br />l� L,� ..n cSy 6,f-� n-r <br />1 hereby certily fhal I have read and exarnined fhis applicntion and know fhe samo fo bo fruo and <br />correcL All provisions c//aws and o�dinances govemmg fhis type ol work will be comp/eted <br />whether speci6ed herein ornoL The gianting o/a pormrt does not presume to give authonfy fu <br />violafe or cancel fhe provisions ol any ofher state or local law regulefing consfruchon or the <br />perfortnance o/ construcfion. That 1 am authorized by tho owner o/ this properfy to perfomi the <br />worklor which application is made and 1 compty n�ifh the Sfate Contracfors Law 18.27 RCW and <br />296.200 WAC. <br />���1-� �z_ `/-08 <br />FEE <br />E o�1 �--c'3`l <br />