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ELECTRICAL PERMIT APPLICATION <br />Cli"Y OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />;rPPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />i?��'� i,..'�.T/�t�t�F' ,�V/c . <br />PROJECT ADDRESS <br />Owner <br />/�/�� <br />Tenanl <br />i>>��,�„ l, ., �- <br />Electricai Conlracbr <br />\ �S�J � <br />Mail Address <br />Mail Address <br />:<«;x,�� ��t�ais <br />Mail Address <br />�°I�1��//��L y`%//UC; <br />Stalo License Number <br />� l U � � Y{ / � �'s-- <br />Proposed Usa oi Building <br />r <br />Descriplion of Work lo �e Done: <br />n <br />>n,J` � �,Yy` <br />City <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />DE IN RACEWAYS, MC OR AC CABLE. <br />City <br />r <br />�- <br />� <br />��;C�'rTl Gc,'•�- <br />Slate/Zip <br />Slate/Zip <br />,�-;. „ 1� 9,f,1,2 <br />�d', � s <br />Phone <br />1'hone <br />City � S�ale2ip Phone <br />�. <br />� �v <br />Conlracl Prico o( Work <br />1��i�L„ ��=P^�'^fi�! . <br />Conlact Person (Plan Review) <br />� <br />FEE <br />� 0 �'�U <br />� <br />CITY Of- EVERETT LOCAL SALES TAX CODE IS 3105 L � Z�(� _Un � <br />I her�by certily Ihat 1 have read and examined lhis apulication and knoiv fbe same fo be frue and <br />1 <br />conacL All p�owsions of la�vs and ordina�ices govemmg lhis type ol work will be completed <br />�rhefher spca6ed'�erein or.noL The �ranrng o/a permR does not xesume fo give authonry to <br />riolafe or cancel fhe �rovisions o(any olher sta(e or local law regulating consfruchon orlhe <br />performance o/ cons�nidion. Thaf 1 am authoiized by fhe o�vner o( fhis properfy fo perfomi the _ <br />work lor wNich epplicalion is mede and I cornply wilh fhe Slate 6onfreclors La�v 1827�RCIN and --� �- <br />29G.200 WAC. �, <br />� ir <br />� � . � / A(�� <br />� /�'::a_.,� . f /� [ (. Z �t.n.�t G / � V /� <br />�� <br />