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( <br />ELECTRICAL PERMIT APPLICATIt�N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETi', WA 98201 �_ag_� <br />425-257-8810 - F.AX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� <br />� � <br />�-3ay I�I�culL�so,� <br />PROJECT ADDRESS <br />Owner <br />Tenanl <br />Elecirical Conlractor <br />Slale Liconse Numbcr <br />Proposed Use of Building <br />G�d`F UU��S1 �sa <br />Mall Address <br />Mail Address <br />Mail Add�ess <br />Description of Work �o �e Done: s �~�� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES l'A?C CODE IS 3105 <br />City <br />Ciq� <br />City <br />yzS 3 �: <br />,UII� `l�?�3 �5b� <br />Stale/Zip Phone <br />Stale/ZID Phono <br />SlaleRip <br />Phone <br />Contract Price o( V�brk <br />/� I1 ` 4�.y •.�-5%' <br />����(,1.v;�.v�l.� VLl �rl�� 311 <br />Contacl Person (Plan Roview) <br />1 heroby certily fhaf I have read nnd exarnined fhis applicafion and kno�v the sarne fo be frue and <br />r.orrect. All pruvisions o(laws and orcli,nances governmg fhis type ol work wi116e compfeted <br />�vhefher speafied herein or noL The gianting ol a pernut does nof presurne fo give aufhonty fo <br />violate or cancel the provisiens o/any other sfate orlocal la�v regulafing construcfion or the <br />peNonnance of constniction. Thaf 1 am eutho�ized by the ou�ner ot tliis property to pedortn fhe <br />work ror which applicafion is made and I cornply �vith the Stafe Confracfors Law 18.27 RC W and <br />296.200 WAC. <br />� `, \ <br />� � ��' lGbL- <br />L�l�i iaturo (� <br />lW ����1 l� <br />I���Fh �,v����� �„ <br />f-EE <br />G� ��6 - \i,�i� <br />