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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT P�?2MIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - vnvw.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />—S�:_� (��P7�/��a;�� /}��/�� _� , � <br />PROJECT ADDRESS <br />_/ <br />�/',� �1'� ti ,�.CC <br />Owner A9ail Address City State2ip Phone <br />;,�.;` �1�� �3� � c�e?�ur� �S�" r=v:.��;�� Cv.Q �1s-fi�z- �� <br />Tenant Mail Address City State/Zip Phone <br />/�, _ <br />;i=�v ;,t�� �� <br />Eleclrical Conlraclor Mail Addmss <br />hi��.v 1h � J�-3 �f <br />State Li�enso Number ` <br />��' _n,.' ni,� <br />i1 <br />� . �i �1 c�! '�f-� 'Ei � C �-' ��.�li 'G� <br />Proposed Use of Buildinc� <br />Descriplion of VJork lo Oe Done: <br />NOTE: WIRING IN NON•DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY Of EV[RETT LOCAL SALES TAX CODE IS 3105 <br />City <br />-: �� y��1 <br />Slale2ip Phone <br />// /-\�(%..JV <br />Conlract Price oF Wcrk <br />/ �i'�'�.i //?/�L�..� t,. p�( — <br />Conlaci Person (Plan Roview) <br />FEE <br />1 hereby certily Ihaf 1 have read and exarnined this ap��licafion and know fhe ssme to bo frue and <br />correct A/l provisions o/ laws anA ordinances govemmg fhis type o/ work will be cempleted <br />�vhether specilied lre�ein or not Thc gianfiny c( a permd does not �resume fo give authonty to <br />viola(e or cancel the provisions olany ofher state erlocallaw regul.�ting construc6on or fhe <br />perforrnance o(conslruc(ion. 77iaf 1 am aufhorized by fhe owner o�this properiy lo perfonn fhe <br />iwrk !or which applicafion is made and i compty irith fhe Sfafe Confracfors Lair 18.27 RCW and � <br />29G.200 WAC. � <br />� � � <br />/, r �! :,fJ �r . -. �� �U/ � �� � � � � . <br />�/ /�— <br />, l �, �� � './i /. .�CL-�' ; <br />