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EL.ECTRfCAL PERMlT APPLICA�'ION <br />GITY OF EVERETT PERM17 S�RVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� C l <br />�'1('�2 ��-.(-�;p�i*r-�:�Q�� �.Q(/� �('e'/'�. ,��A 9G�� <br />PROJECT ADDRESS � <br />Owner <br />Tenant <br />Electriral Coniracior <br />Address <br />Mail Address <br />Mail Adtlress <br />('nm/YIr(' ;n/7�n/�/ <br />State License Number <br />Proposed Use of Building <br />Ciry <br />Ciry <br />City <br />, .cG � �Zl - F'J.� i <br />State2ip <br />Stale2lp <br />n��� <br />Phone <br />Phone <br />-U3:iJ <br />Phone <br />� 5 91.J . L'iJ <br />Contraa Price ot Work <br />����.,�� / J % �c3���,�, <br />Cont2d Person �Plan Review) <br />Description of Work to Be Done: ,�/7�1.1 lZ�l��/Ol� Of �� !('1� �/�iL '� i�/��'7 '�-dJ"Il� <br />n/on,���ircrv�l,l�inu.��r � <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE I� 3105 <br />1 he26y certily Ihat 1 have read and exarnined fhis apolicafion and know fhe same lo be true and <br />co�recL All provisions o//aws and ordinancros goveming this type of work will be completed <br />whelher speci(red herein or noL The granting oI a portnR dces nof prasume lo give authoury fo <br />violate or cancel the provisions ol any other state or local law regulating consWcfion or fhe <br />per/omiance of cronslruchon. That I am autho�zed by (he owner of this property to pedo�m fhe <br />work lor which application is made and I conrply with fhe Stafe Contrectors Law 18.27 RCV/ and <br />79fi ?00 WAG <br />FEE <br />r�1/l� � 1 � �� <br />