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7l Z�3��'Z- <br />EL=CTRIC�!_ �ERiVIIT APPLICATION <br />CITY GF E°✓ERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 J a�a7_O7 <br />425-257-B810 - FAX 425-257-8857 - www.everettwa.org y <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />7�l S �t/ �l/p�.���/�� <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />f� 1��. Zl/�su! <br />Mail Addross <br />Eleclrical Contract: r <br />Mail Addross <br />��//���/� �/�G� <br />� State Licenso Number <br />��Si/�'��%�p �,5�%�SS <br />Proposed Use of Building <br />Description of Work to 0e Done: <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />Clry <br />Cily <br />G-o7i2-a � <br />Pho/n/oLf' <br />7��/ <br />StalelZip Phono <br />��S'L` �ST�'/DO r��/D//, GU� 9� <br />ary Stato���ZS)ya'rp P�`7Z3 <br />�9� .� <br />Conirect Price ot Work <br />�r / <br />Contacl Person (Plan Review) <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereGy cerfily Ihat I have read and examined Ihis applicalion und know Ihe same ro Le frue and <br />conecl. All provisions ollaws nnd ordinances governmg (his fype oI work will Ge complefed <br />whefher specilied herein or noL The gmnling o( a pe�md does not�resurne fo give aufhority lo <br />violafe orcancel fbe provisions o(any othersfalo orlocallaw re�u afing consVuchon orfhe <br />pedormance ol consWction. Thal I am authorized by fhe owner o/ (his proporty fo pedorm fhe <br />work lor which applica(ion is made and I comply with fhe Sfafe Contracfors Law 1 i3.27 RCIh� and <br />296.200 WAC. <br />? �� - � `�g <br />