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�L�CTF�ICAL PERMIT API�LI�ATION <br />CIiY C1F EVERETT P�RMiT SERVICES <br />3200 CEDAR STREET, EVER[TT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS AF'E ACCEPTED FROM 8 AM TO 4 PM <br />�r ` <br />G% K� •� � �J�'�i �/'r't��.i �.✓�� <br />PROJECT ADDRESS <br />Owner <br />/�l( <br />Tenanl <br />�.� ��>�w��� �l_ f <br />Mail AdCress <br />Mail Address <br />ElecUical Conlractor Mail Address <br />,H�S U�� C G �R�C- <br />State License Number <br />� <br />i' 3c-. ' - <br />Proposed Use f Building <br />Description of Work to Be Done: <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 />Cily <br />Cily <br />City <br />Stale/Zip <br />State2ip <br />Slafe/Zip <br />� �v� W <br />Conlracl Price o( Work <br />Phone <br />-35�= ; <br />Phone <br />'.ii%—/j5 �: <br />Phone <br />Conlact Person (Plan Review) <br />:J P � `�r. <br />1 hereby certi(y that I have read and examined Ihis application and kno�v fhe same fo 6e true and <br />correct. All provisions olla�vs and ordinarces governmg Ih�s type o( �vorh will �e complefed <br />whefher spec�6ed he�ein or noL The granting o�a permd does nof resumE fc �ive authordy to <br />vrolafe or cancel the provisions of any other stale or /oca/ Ia�v rec�uPting const� tic6on or fhe <br />perlonnance o/conslniction. Thaf 1 am authorized by the avner of this property to peAorm fhe <br />�voik !or which applicafion is made and 1 compty �vitli fhe State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />� <br />;1%"�.l - ;�z. �C�� /l r �' �� s' <br />i�nawre � ate <br />FEE <br />�o51/-e9�^ <br />.t1�i�J r - <br />