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ELECTRICAL F�ERMI1' APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-?.57-8810 - FAX 425-257-8857 –www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � p �(("O S <br /> ' % � � 5C EvcRe7 i��lA�� t.�g� �3 <br /> PROJECT ADDRESS <br /> S�z'a�� s� �vcrcfif c:.LL <br /> Owne� �.1ai1 Atldress City StatelZip Phone <br /> �u��HoS Su.h . <br /> Tenanl Mail Addmss City StatelZip Phone <br /> ._S �ICYEt�s ELEL�Z�L�21� z,,�,'`PL �C ��2��N�;v� W�- sxzzs /Zob�91�-3�53 <br /> EleCtriCal ContractOr Mail Address _� City SlatelZip Phone <br /> . � �1 <br /> �S,ry�E�Cj:�L 9S� c3 � ! _ /,[ od� �� <br /> Slale License Number Contract Price of Work <br /> CfGv:�{;�,yyzl5 (���SLJ -3��3 <br /> —T <br /> Proposed Use o(Building Contact Person (Plan Revieva) <br /> � <br /> Descriplion of Work to Be Done: ����Or�✓�""`'`"f i � N�'-.J ,(.�u �ZctidS Sa�i <br /> ��i�l/�"S -t' Ju-f�e 'f3 <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily that 1 have read and examined this application ard know the same fo be true and <br /> correcf. All provisions ollaws and ordinances governmg this type o/work�vill be complefed <br /> whether speci6ed herein or not The g�anting o�a permit does not resume to give aufhority fo <br /> violate or cance/the provisions olany other state or local law reguPfing construclion or the <br /> performance o/conslruchon. Thaf I am authorized by the otvner o/this property to per/orm the <br /> �voik lor�vhich application is made and I comply�rifh fhe Sfate Contractors Lau� 18.27 RCIN and <br /> 29f.200 WAC. <br /> Signa W rc Date <br /> � <br /> � / � � �`J <br /> I <br />