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ELECTRICAL PERMIT APPLICA'TION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8E57 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�f3o S.� E✓��ETf �c< <✓9 _ <br />PROJECT ADDRESS <br />S-a� /O <br />L—I �5—l0 � <br />ST��t�«t+�,�—c✓�tU���D �n�E�A wt ��n. t�iX II/oY �✓E/lE1Y 9$Ze6 <br />Owner Mail Address City SlalelZip Phona <br />{MDIiIL ,�. LWl� EKP/l�"Sf <br />Tenant rdail Address city Stale/Zip ���r� <br />(dA(�- IZ.'f� 1J6Y//.Wl� M/t. w!_ �M7L� Gff/B4 :..4.DT0� <br />Electrical Conlraclor Mail Address <br />pr�}T10Sca�►mj <br />State License Number <br />Mrn�+�sr�E ,2kpMa �. s��1✓�cr'9 <br />Proposed Use of Buitding <br />City <br />$ <br />SlatelZip <br />SDD �i <br />Contrect Price of Work <br />5>F✓� 7�sFn c►�✓ <br />Conlacl Person (Plan Review) <br />Phone <br />Description of Work to �e Done: /N3 f� O�✓� I✓L'�''� re eH»�►,�9�fD i��� /�l�N ��f/��-y <br />Cod,✓FcT �o �XI59►�� S I�� Lltit ui7. <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that 1 have read and examined Ihis appbcation and know the same lo be true and <br />correc�. All provisions ollaws and ordinances governinq Ihis type � work will be completed � I��, � <br />whether specified herein or noL The granting oI a permit does not resume lo give aufhority lo i � Cl <br />violale or cancel fhe provisions olany ofher slafe or local law regu abng cor.sfrucLon or the <br />performance o/%onstruc6on. That 1 am authorized by the owner ol this property to peAorm the <br />work for which apppcation is made and I comply with fhe Stafe Contracrors Law 18.27 RCW and <br />29G.200 WAC. 1 1 <br />.�� ul'�° <br />