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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 8 CREDIT CARDS ARE NOT ACCEPTED <br />�� v��w�� nE � 76 C-, �s sr�-r <br />3U � �/ /�,,,� ILT�o IS�Ut� <br />PROJECTADDRESS <br />�1'�Ar'I SGtiv�1 kYGJ 30/ w r,Urc ���r� r�u;�e-rr ,�,/�1 Qb'�o 3 <br />Owner Mad Adtlress City � Stale2ip Pt�one <br />Tenant <br />hlail AJtlress <br />City <br />State/Zip Phone <br />IQ�C- �ce�7�ziL 3iZ/6 �y�c1 �)v�fw rca w�vy w� ��oz� <br />EleCtriCal ContraClor Mail Address City StateZp Phone <br />�Ul�°_EE�146�-Ti-� <br />State License Number <br />(�,�iS S7/-17 �0 �v <br />Proposed Use of Bullding <br />u 3o G <br />Contract P of Work <br />�ALU/i✓ PAr . <br />Contact Person (Plan Review) <br />Description of WorK to Be Done� ��UU�' U/� GvALf �/V (QQ L�/� �{��L`�u/� L)N/'j <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 />I h,e�eby certily fhaf I have read and eramined this <br />cor.��c.t All provisions o/la�vs and ordmances gov <br />::helher spec�fied herein or noL The granting oI a <br />mclafe or cancel the provisions ol any ofher stafe c <br />peAormance ol consfruction That I am authorizec <br />work ��r which applicati�� ade an�� w� <br />29@ 2GO W� � <br />✓ <br />a6on and kno�v Iha same fo be hue and <br />this type ol work will be completed <br />does nof presume tc give authonty to <br />' law regulafin� construcfron or the <br />� o�vnerol!his property b pedorm the <br />State Confracrors Law 78.27 RCW and <br />6����0 <br />FEE <br />���; b7- l3 <br />