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ELECT4ICAL PERMIT AP�'LICQTION <br />CITY C1E EVERETT PERMIT SERVICES <br />320u C[DAR STREET, EVERETT, WA 98201 <br />425-257-8(S10 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />,.�1��.� `�\. �\_L'_��_�<' r��V`�.�V ��r`!�� <br />PROJECT ADDRESS � 1�j� %``� <br />,��: <br />� ' <br />�l� `i: <br />\ <br />��-;:�\\;>>\ l�v: �.�� 1—�-�\. ��>,`1`. �r� Y�G�n,�.�'" �`'_ ������`��_�:. <br />Owner Mail Address City Stale2ip Phone <br />�� <br />Tenanl <br />��7 � ;, '=>.r <br />Mail Address <br />Eiectrical Contraclor M,II Address <br />�"1 �- i i�0 i1? C���S �t L_ <br />State License Number <br />Proposed Use ot Building <br />Cily <br />('�.) nv� <br />Ciry <br />Slale/Zip <br />i,��l `'��'�' <br />Slate2ip <br />� �� �' <br />Conlract Price of Work <br />Phone <br />y�-��,a�-"���,5� <br />Conlact Person (Plan Review) <br />�-- J <br />Description of Work to Bo Done: C�"sv�t�,��\ C.��,.;_ �� �?:A.1.�� `�- W�;`.v ��� <br />NOTE: WIRING IN NON-DWELLINGS IS R[QUIRED TG <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />FEE <br />1 hereby certily fhat 1 have read and examrned this application and kno�v fhe same to be true and <br />correcL Aq provisions ollaws and ordinances govemin� this type o/ work �vill be complet�d �, <br />trhefher speci6ed herein or noL The granting o(a pernut does no( presume fo give aufhonty fo <br />violate or cancel fhe provisions o( any other state or loca/ la�a regu/afing consfruclion or the ,� ., � 1 <br />perfemiance o/ constrcction. That 1 am authonzed 6y fhe o�vner oI fhis property to perfomi the <br />�vork for which application is made and 1 comply �vifh the State Confractors Law 13.27 RCW and .' � �7 <br />296.200 WAC. � ' i � <br />� �'. . � �; ,� <br />��,`�� ;� � `���� �- ��_ �, .,l i <br />c �,,,, � i� �.� n��� <br />Phcne <br />