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( <br />ELECTRICAL PERIV�l� APPLit�ATION <br />CITY (JF EVERETT PERMlIT SE;�VICE� <br />3200 CEDAR STREFT, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8,4M TO 4 PM <br />��' � 3 L o�,�e l l�� C��«tl- �,.� �A �i g-2 c� �3 <br />PROJECT ADDRESS <br />� <br />�� <br />Gwner <br />Tenant <br />SJ���� <br />Mail Pddrass <br />Mail Address <br />Cily <br />Cily <br />Slale2lp <br />State/Zip <br />a —a—r� <br />Gioa2—�Q <br />Phone <br />Phone <br />(-� (,J ��.et — <br />Elecirical Conlraclor Mail Address City Slate2lp Phone <br />Slale License Num6er <br />Proposed Use of Building <br />Y�. +\ <br />Descnption of Work lo Be Dono: l� I'e �: t� �`'� \ U� �� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETI' LOCAL SALES TNC CODE IS 3105 <br />Conlract Prir,e of Work <br />Contact Person (Pian Review) <br />1 1^ <br />y r,erti/y thaf I have read and examined this application and know the same fo bo true and <br />All provJsions o/laws and orrlinances goveming fhis type o( work will be complefed <br />r speci�ed herein or not. The granfing o/ a pem�rt does not presume to give author.ry to <br />or cancel fhe •rev(sions o( any ofher stafe or local la�� regulating cons Wction or fha <br />iance o( cons�ruction. That I am authonzed by the owner o.+this�ropertylo Fedomi the <br />r which application is mede and / comply with tho Sfate Controc,or.; Law 18.27 RCW and <br />� <br />FEE <br />L I �a� � °� <br />� <br />i ,� /.�� �—� � ( C) _ <br />^ ;'� , <br />