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ELEG'TRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everethva.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />c.P U ! �7 � C.ind/�'G'� �M o..0 � �j ��2- �� � L. � E'�"tnl� , R 82l) � <br />PROJECT ADDRESS <br />O�vner <br />L1aii <br />Ci�y <br />SlatelZip <br />Phone <br />I.�P/ �Ar71i1 1 GIIA�C-e._- �/AMti.l.� <br />� <br />Tenant A4ail Address City State'Zip Phone <br />���N�1 �.,IP���n�, 13300 'ho��.U�—F r�(-1-�.s�.-/ �/lc�ePl U��- `IB02 <br />Electrical Contractor �.1aii ACCress Cily State/Zip Phone <br />��s 359 - l 902 <br />K��i � r����71�i � 4�e,� <br />Stale License Number Cantract Price of Work <br />�Cph1'(i �,.�'0.�t? <br />Proposed Use of Building <br />Description of Work to Be Done: � <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 />Contact Person (Plan Review) <br />FEE <br />��� (�F <br />I here6y certily tliat 1 have read and examined this applicalion and Wiow fhe same fo be true and � r�� � 1 ��Q <br />correcL All provisions ol la�vs and ordinances govemmg fhrs type ol �vork will be complefed � C) <br />whe(her specified herein or noL The granfing o/ a permd does not resume ro give aufhonty (o <br />violafe or cancel the provisions of any ofher sfate orlocal law reguPting consfruclion or the <br />perlonnance o/ consfruction. 7hat 1 am authonzed by the owner o/this property lo peAorm the <br />work Ior �vhich applicalion is made and f comply wilh the Stafe ConVacfo�s Law 1827 RCW and <br />296.200 WAC. <br />-z�i-� <br />