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ELECTRICAL PERMIT APPLICATIAN <br />CITY OF EVERETT PERMIT SERVICES <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 />� v'J C � I Su �-l� �� <br />PROJECT A�7RESS �Vzf��,�r w O� C3 �� <br />Owner <br />Tenant <br />Eleclrical Conlractor <br />.�^.yI.cxu�i �9737P <br />Stale License Number <br />0 t��i C� / Se,�vi�v � <br />Proposed Use of Building <br />Description of Work to Be Done: <br />Mail Address <br />��7 5� �ve <br />Mail Address <br />/S(o/O �aS��' <br />Mail Address <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERE'iT LOCAL SALES TAX CODE IS 3105 <br />City <br />City <br />Cily <br />Stale/Zip <br />Slale2ip <br />� D 709-1�/d� <br />C/ U ZCJ <br />hone <br />�yzs 3s3- ° <br />Phone <br />'v4. �i°3%S <br />zs�Phone <br />2z3-Y6f <br />�SSU� <br />Contract Price o( Work <br />(1�,� �� Pre_�-I zs r� z <br />ConlactPerson (Plan Review) <br />/ here6y cerfify (hat 1 have read and examined this application and kno�v the same to be frue and <br />correcL All prov,sions o(/aws and ordinances govermng thrs type o/ �vork will be completed <br />4+�ko!!,er epoc;ned herein or not The granting o/ a pennit does not r��sume to give authonty fo <br />violate or cancel fhe provisions o( any other state or local (aw reguPting conshuction or the <br />perlormance ol conslruction. That 1 am aulhonzed 6y fhe owner o/ this property fo peAorm the <br />work (or which applicafion is made and I cornply with the Stafe Confractors Law 18.27 RCW and <br />296.?OQ WAC. <br />I � A , <br />FEE <br />E��Uq -1 �8' <br />