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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETi', WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />j oS ,sE Et�P�� n��tu.. wA �/ Ev.�-Ti ,//� � 99Zo v <br />PROJECT ADDRESS <br />Owner <br />Mail Address <br />CI�y <br />State2ip <br />Phone <br />5�2 [nIT QCS ,s os c � Eue�efl ,�crli�- �✓�* y ki/e�e�% r.✓A . 9$ zd 8 <br />Tenanl Mail Address City State2ip Phone <br />MvZA-IL 33�R ch��rronly d��.n �o�T �+<<+s 6L 9-97vt3 <br />EleclricalContraClor MailAddress Cily Slale/Zip Pho,ie <br />r-co��a MJZ�ta�$e b�GLT' — <br />Sfale Licenso Number <br />� <br />Proposed Use of Building <br />S�dD � <br />Conlract Price of Work <br />,vj��e/L ,G/>xSrz� <br />. , <br />Contact Person (Plan Review) <br />Description of Work lo Be Done: ���cc._l�e,r5 ��-�vt �d -D'- Q<<f'�j a� T h e ✓aa� <br />� <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 IS 3105 <br />1 hereby certi(y that 1 have read and ex2mined ihis application and know i8e same to be fnre and <br />correct. All provisious of laws and ordinances goveming fhis type o( work wi!I 6e completed <br />wliefher specified herein or nuL The granting o( a pomut does not resume to give aofhonty to <br />violafe or cancel the provisions cl any ofher state or local law reguPting constructio•i or the <br />perlomiance of construcfion. That 1 am authonzed by the owner o/ fhis properiy fo perform (he <br />work for which application is made and 1 comply wifh the State Contractors Law 19.27 RCW and <br />296.200 WAC. <br />FEE <br />