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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 />2�o s�J �dta�lkn <br />PROJECT ADDRESS <br />�1 ��ato.� C-a,..;l <br />Qwner <br />(��P� W�� I� .T"Cr. T. <br />Tenant <br />. , <br />Eleclrical Contra or <br />APPLICATIONS ARE ACCEPTED FROMi 8 AM TO 4 PM <br />Mail Address <br />Zio <br />Mail Address <br />� <br />Mail Address <br />u/Y/ vE�4/ ��So <br />Slate License Number <br />n�;NiNy %D��rcEs <br />Proposed Use of Buil ' <br />Description of Work to Be Done: <br />/+{ �aEr2.v <br />� <br />� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS. MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES 7AX CODE IS 3105 <br />! z-� 5'��.3 <br />�/ 3/Z -� <br />City Stale2ip <br />wa� Sv��cs�rC. <br />City � Stale2ip <br />�253 <br />'�. �4u 6�, q�o�� q� <br />Ciry State2ip <br />�/� Siod . e• <br />Contract Price of Work <br />� <br />Phone <br />Phone <br />Fhone <br />I�t�.��+b�EJ 253•939•SSoI <br />ContaC Person (Plan Review) <br />FEE <br />50� <br />I hereby certily fhat I have read and examined this application and know fho same to be frue and t 7 <br />correcl. All provisions ollaws and orcJinances goveming this tyNe o/ work will be complefed � I.� ��� �� <br />whether soecified heiein or nof. The granting ol a perm�f does nof resume fo give authonty fo <br />violafe oi cancel the provisions ol any other state or loca! law reguPfing construction or fhe <br />perloimance o/consfruction. Thof I am authorized 6y the ownerolfliis propeRy fo perform the <br />work lor which applicaG'on is made and 1 comply wifh flie Stafe Conlraclors Law 18.27 RCW and <br />