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13C% � <br />PROJECT ADDRESS <br />r <br />Cr�� <br />Owner <br />ELECTRICAL PERMIT APPLICA��'IO�d <br />CITY OF EVERETT PERMiT SERVICES <br />3200 CEDAR STREET, EVEftETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />-„ l,�i � '✓PrP7'f- �� 2 Oy <br />��zO-S��/��/�l- ���flr <br />Mail Address Cily <br />/ D_2.�-0] <br />�07i� - /3-z <br />p�'ll J' <'!%6 � �/S'�-C <br />SlatelZip <br />Phone <br />'�/`hiw �C'nl% s�!/�7—t' <br />Tenant Mail Address Cily State/Zip Phone <br />ElecUical Contractor Mail Address <br />Slate License Number <br />r <br />G � c -� <br />Proposed Use of Buildin� <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 CF EVERETT LOCAL SALES TAX CODE IS 3105 <br />City <br />S�ale'Zip <br />�Z«r,— <br />Conlract Price o( Work <br />/ � <br />G'./'h�P Jc�(7� <br />Contact Person (Plan Review) <br />`% �t/�'S� C� H.(�/G' <br />I hereby ceAily that 1 hava read and examined Biis application and know the same to Ge true and <br />correcL All provisions ollaws and ordinances govemmg th�s type of �vork wi116e cornpleted <br />whefher specilied herein or noL The granting of a pennd does �ot presume to give authonty to <br />violate or cance/ Ihe provisions ol any other state or /ocal law rc�gulaBng consfruc6on or the <br />perfonnance olconstruction. That I am aufhorized by the owner oltfus property fo perform fhe <br />work lor whicb applicalion is made and I comply wifh Ihe State Contractors La�v 18.27 RCW ard <br />2�6.2001NAC. � <br />6 <br />`-C�-C�T� <br />�� �'�- � `v � <br />FEE — <br />Phone <br />_E� rrc�-�3 ' <br />