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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 r _ g O q <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org & O q 1 2 `1 y 6 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECT ADDRESS ZU <br />r:. <br />Mail Address <br />City <br />Statelzip Phone <br />Tenant Mall Address City SlelelZip rnone - <br />g66 L(—ISNI <br />IS'- <br />Electrical Contractor Mail Address l..1/ f�_ SlaletL�f �Z� '3 Phone <br />PC it <br />/(I Zs trc>r3 D <br />State License Number Contract ice o Work <br />Proposed Use of Building Contact Person (Plan Review) <br />Descriplion of Work to Be Done: 0 C <br />1 a17 FlrS. d <br />SP At - %I <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAY$, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />!hereby coftily that 1 have read and examinod this epplioelion rind know the same to be taro and <br />Gurrvul. riff NIWlmv... V - a •••• •a •• - -' <br />whether specified herein ornol. -The granting of a pormll dons not nrosumd,to:giva Ziff pn to <br />violate,or,cancel the. nrovlslons of any othorstolo orlocal law regulating construction ctlhe ' <br />portormance of construction. That 1 am authorized by the owner of this P�roperty to peAorm the <br />work for idl application is meda and Pcomply With ,he State Contractors Law itl.27 RCW and <br />296,200 C. - <br />Lib <br />ignalure:... <br />8496 0� iU0313 31b1S11d Ad6S 8 60OZ •67'='C <br />