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EL�CTRICAL PERMIT APPLICATION <br />CITY OF E'VEREI T PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — v.�ww.everet!wa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�`f ��.e✓�'�'��--/�'� �/ ��7f 1�,0, <br />PROJECT ADDRESS ��� � <br />owner <br />Tenant <br />�o �bx �alZ-7 <br />Mail Address <br />Mail Address <br />Cdy <br />Cily <br />St.rie2ip <br />S�ate/Zip <br />Phonc <br />Phone <br />�lj/H l�� <br />Eleclrical Contraclor Mail F��ldress Cily State/Zip Phone <br />Slate License Nu:nber <br />�O�a�I..�C211�/A / <br />Proposed Use of Building <br />�6/Soa. °�. <br />Conlract Price of Vlbrk <br />Conlac: Person (Plan Review) <br />Descriplion of Wark to Be Done: /`��^'/�� �ffS, OJ�/ .� /•Z.�i�Y.•�G �Sf � D'�� <br />�G�/S /�t� G <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SAL[S TAX CODE IS 3105 <br />I hereby certily that 1 have read and e,ramined Ihis application and kno�v the same to be true and <br />correcf. All provisions o�laws and ordinances govem�ng this type oI work will be complefed <br />whefher specif�ed herein ornoL The granfing ol a pernut does net resume to give authority to <br />violafe or cancel Ihe �rovisions ol any ofher state or local la�v reguPting construcfion or the <br />pe�/ormance ol consfruction. Thaf 1 am aufhorized by the owner o/ this property tc perlonn fhe <br />work /or which applicafion is made and 1 comply with the State Contrac:ors Law 18.2i RCVV and <br />296.200 WAC. <br />�. T.✓' �' 9/y�.� <br />FEE <br />