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E�ECTRICAL PERlVII�' APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />32U0 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 - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />��_ �o,ti,��F�IJ <br />PROJECT ADDf2ESS <br />y�5 <br />2�6 <br />t3a6 G�S(�� �Y�� ��C���2/� fC�,�r?.�/T 9('ao3 a�4� <br />Ownef Mail Address City Slate/Zip Phone <br />Tenant Mail Address City State/Zlp y2 yhone <br />S <br />�Ct���l/�E/L .SK� �lp�/ �L/ffl//Pl% ��/ rL �/ 2��4i <br />Electrical Contractcr Maii Address Ciy Stale2ip Phone <br />�Y��-�ssi yz c �° <br />State License Num6er <br />�SF/2- <br />Proposed Use of Building <br />Description of Work to Be Done: <br />L���-� Lo �c�-rox.a <br />NOTE: WIRING IN P�ON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT i.00AL SALES TAX CODE IS 3105 <br />Contract Price of Work <br />Contact Person (PI2n Review) <br />I hereby certi(y th�:f 1 have read and examined this applicatlon and know fhe same to be trt�e and <br />correct. All p�ovi!.ions of laws and ordinances governing this type o! work will be completed <br />whether specdied herein or not. The g�anting of a permit does nof presume tc give authonty to <br />violate or cancel the provisions of any other state or local law regu/ating construction or the <br />perlormance of consVucLon. Thet 1 am authonzed by the owner o/ this property to peAorm the <br />work (or which applir.ation is made and I compty with the State Contractors Law 18.27 RC W and <br />296.200 WAC. , <br />7�/3�a� <br />FEE <br />�'s' 0 6 <br />�c� � � —5 �. <br />