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ELECTRI�AL !'ERMIT APPLICATION <br />CITY OF EVERETT PERIlAIT SERVICES <br />3200 CEDAR Sl'REET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE EICCEPTED FROM 8 AM TO 4 PM <br />7/�5/ �vr��,���i� (,��r <br />PROJECT ADDRESS <br />�RrArivr Kai'�.�T/tJ /l//5 �u, <br />Owner Mail Aduress <br />Cily <br />,7.2 U <br />StalelZip <br />S-1�- I� <br />CllO�-O�J�o <br />Phone <br />l7RA/1-/v'VO 7/-?N .EvrnGxttN �%4� �vt,r� rT �,i//% 9f'�-? .�3y-GSS-/G,29 <br />TenBnt Mail Address City Slale/Zip Phone <br />Electrical <br />Mail Address <br />,�f'D L � N/ - OyS/- O� <br />Stale License Number <br />�SPrtr✓s o Sr�.v� _ <br />Proposed Use of Building <br />Slale/Zip <br />� �%�. � <br />Contract Price of Work <br />fA7 /foWr <br />Contact Person (Plan Review) <br />Description of Work to be Done: li�J'fo �% d� c�r i�P c I�u r^a � r�e or� <br />pn .�aJJ`� �arth o„a� �Jou-f�i a/�vu-�eohs <br />NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES 7AX CODE IS 3105 <br />FEE <br />Phone <br />1 hereby certily tliat 1 have read and examined this applicafion and know !he same (o be tnre and — I � G� S— L7 �� <br />carrecL A/l provisions ollaws and ordinances goveming fhis type of work will be completed (� <br />whether spec�6ed berem or nof. The granfing o/ n penmt does not presume to give aofhonty to <br />viola(e or cancel fhe provision : o/ any ofher stafe or local law regulafing cons(ruction or Ihe <br />pedomrance ol conslruclion. That 1 am authonzed by the owner ol this p�operty to peAom the <br />work /or whir.li applicafion is made and I cornply wifh the State Confrac(ors Law 1827 RCW and <br />296200 WAC. <br />� /y/ <br />