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( <br />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 6 AM TO 4 PM <br />✓O�` •JiG�..PWc2C1 � �1�. �L- �!� <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />Mail AdBress <br />A/o'le a� ��i,S �;rtC <br />Mail Addmss <br />�s� �/ <br />Electrical Contrador <br />Cily <br />City <br />c /G '�3( �'O� /��e. ,✓W <br />Mai� Address <br />�z �sl�lf�c �7i� � <br />State License Number <br />Proposed Use of Building <br />Cily <br />1 � r <br />Description of Work to Be Done: GlV`O� �EC�Q�� `s i <br />�, f <br />NOTE: WIRING IN NON•DWELLINGS IS RE�UIRED TO <br />BE IN RACEWAVS, MC OR AC CABLE . <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerli(y fhaf I have read and examined Ihis , r�plic� <br />correct. All prov�sions ol la�vs and ordinances goveinmg <br />whether spea/ied herein or noL The granting oI a pennd <br />violate orcancel fhe provisions ol any ofherslafe orlocai <br />perfom�ance o/ construcfion. That I am aufhonzed by the <br />work lor �vhich applicahon is made and�comply with fhe <br />296.200 WAC. � <br />�jl� � �'�� <br />State/Zip <br />State/Zip <br />State/Zip <br />i-m ��' <br />!'�l %� <br />Contrad Price of Work <br />Contact Person (Plan Review) <br />j/S. �7 <br />ce�l��,, <br />and knotv Ihe same fo be Uz�c and <br />ype o/ work nall be camplefed <br />� not resume to give aufhonty fo <br />reguPting consVuction or the <br />�er o( fhis property to pednmi the <br />r Conhacfcrs Law 18.27 RCW and <br />/z-/�- II <br />Phone <br />Phone <br />Phone <br />FEE � <br />5D , 0 <br />EIll2-l07 <br />