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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 ACCEI'TED FROM 8 AM TO d PM <br />��� �n% �t�f (/E_� t //c`�TT <br />PROJECT ADDRESS <br />�Arinc�v�c �J �C �.o2�{,a2A <br />Owner Mail AdOress Gty StateZp Phone <br />Tenant <br />Mail Address <br />^C%-� <br />City <br />Slate2lp <br />Phone <br />�Asis,/_� E�c'�2,•� /�/�/3Z Z7y�;AiiFNE /��i i.�A• �'ri/9 <br />Eieclrical Conlractor Mail Address City S�ate2ip Phone <br />� <br />/ ��, � � �: ��j�; y ; ��sTs�� %�7/�;. <br />State License Number ' <br />�, <br />,��4? f;. �_ �"%�.��t ��AR.Ayfl-� _ <br />Proposed Use of Building � <br />�/�v� , � <br />Contract Price of WorY. <br />ContaclPerson (Plan Review) <br />Description o( Work to Be Done: �U �..��' ��'/I � AN-/ %D /;A ,_q�,t� <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 hereby cerii�y thaf I have read and exaniined fhis applicafion and kncw the same fo be true and <br />cormct. Al/ provisions ollaws and o�dmances governing flris fype o/ u-ork will 6e complefed <br />wbefher specilled herein ar not The granling ol a pemid does not presume to give authonty to <br />violafe or cancel lhe provisions ol any oihrr stafe or lucal law regulating consfrucfion or the <br />perlonnance ol consfruction. Thai 1 am autho�ired 6y the owner o( lhis propeRy to peAorm the <br />wor� lor �1�hich applicalion is made and 1 comply wifh fhe Stale Conlractors Law iB.27 RCW and <br />296.200 WAC. <br />FEE <br />�� <br />,, : ,� . � ,�,_-.,.,_,, ���.,� <br />Ii9natum Dale - <br />