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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.everetWo.org 3 1 _ 0 7 APPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM % 70 3 (9o9 <br />n v S <br />PROJECT ADDRESS C V GI 0 Z (� L <br />Ll <br />? <br />13 <br />— Mail Address �- City Stelelzip Phone <br />Tenant Moil Addross City SIatCRip Phone <br />�bG <br />A-1K+0C1 lsZ)12- <br />r�Ls� sir Y i GfZG5 <br />Electrical Contractor tAailAddress CityStalS2ip LUfL , cPhone <br />State License Number Contract Price of Work <br />Proposed Use of Building y �T� Contact Person (Plan Review) 1 <br />Dascripllon of Work to Be Done: ! i o c" <br />NOTE: WIRING IN NON -DWELLINGS IS RFQUIRED TO FEE <br />BE IN RACEWAYS MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE 15 3105 <br />1 hereby certify that I have read and examined this application and know the same to be true and — o3 GOpI <br />correct All provisions of laws and ordinances govemrng this type of work wilt be o�omp/eLited �� I <br />whether specified herein or not. Tho granting of a permit does notpresume to give authontyto <br />violate or cancel the provisions of any other state orlocal law reguinting construction or the <br />paAorrnanco of constmchar. That 1 am authonzod by the owns, of this roporty to pArform the <br />work far which application is made and I comply with the Stote Contracto s law 18.27 RCt4/and <br />296,200 vY <br />(? UzDa'--, <br />�ignaturo ont <br />7 Li.11 ='1' 9IM313 31d1S11V AVSO:OI LOOZ 'Z 'IOW <br />