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ELt�TRICAL PERMIT AP?LICATION <br />ClTY OF EVERETT PERMIT SEFtVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — �niww.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />�/ z �1 � ��r���,,, �v� <br />PROJECT ADDRESS <br />-�- c <br />Owner <br />Mail Address <br />Statc2ip <br />yzs- <br />Phane <br />S i�7'✓I "� <br />Tenant Mail Address City Sta�^2ip Phone <br />3(�J- 3k'9-?GI �(o <br />n�,� (�- e�,�i>� � 5�- GU - Nor�-��CFtr�rr�vo di� ��ns1-nia .I�S` �v/1.Gi'�zfr�z <br />Electrical Cont�actor Mail Address City State/Zip Phone <br />/ / // �' C � Z[n (n i'I�l G7 <br />State License Number <br />�r�� � � � <br />Proposed Use of Building <br />Description of Work to Be Dane: %yi0 �i �.P �'�� LI'r'IZ C <br />NOTE: �VIRING 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 />704 �, � <br />Contract Price of Work <br />Contact Person (Plan Review) <br />I here6y certify ihat I have read and examined this application �nd know the same to be true and <br />correct. Al/ provisions of /aws and ordinances governing this type of work will be completed <br />whether specified herein or noL ihe grenting of a permd does not presume to give authonty to <br />violate or cancel the provisions of any other state or local law regula;ing construcfion or the <br />periormance o/ construction. Tnat 1 am authonzed by the owner of this property to perfoim the <br />work for which application is made and I comp/y with the State Contractors L3w 18.27 RCW and <br />296.200 WAC. <br />���'�� <br />.��,�u�� <br />_2 <br />FEE <br />�� � <br />C4/D -/Zlo <br />