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ELECTR�CAL PERMIT APPLICATION <br />ClTY 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 />�'�.. I� G. V 1 �=�v'� �:�� ���ni'f�l \' W� <br />PROJECT ADDRESS �T <br />-'� �e x �o <br />Owner <br />Mail <br />�� <br />Tenanl Mail Addmss <br />� ITE #A <br />�l� �,����5 f41�`7 P�a►J+�E�z wAr <br />Eleclrical Conlractor A1ail Address <br />r�t��i�;`e��,�i F� <br />Slato License Number <br />Proposed Use of Building <br />i� <br />Description of Work to Bo Dono: � L <br />NOTc: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN R,4CEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />City <br />City <br />C <br />City <br />� � �r� <br />' �'jc J� <br />� <br />S�ale/Zip <br />1 hereby certily fhat 1 have read and examined fhis applicafion �nd know fhe same fo <br />correct. All provisions olla�vs and ordinances goveming tlus type o( work will be con <br />whether speci/ied herein or not The granting o/ a penmt does nat presume to c�ive a <br />violafe or cancel the provisions o/ any ofher state or /oca/ larr regulating construc(ion <br />perfomiance o/ construction. 7'haf 1 am aufhonzed by the o�vner of fhis property to p� <br />work lor which application is rnade and I cornpty �vith fhe Sfafe Confracfors Law 18.2. <br />296.200 WAC. i <br />� . ; / <br />. :�" � � <br />%ji� � / L� %'l G <br />� <br />Slale/Zip <br />i_ag-�D <br />�'ido /--/05 <br />Phone <br />Phone <br />Z'�3� 3�70 - % % �L, <br />Phone <br />� ] Cxi <br />Contract Price of Work <br />�e� �rz�i � �o -�c���'Z_ <br />Contact Person (Plan Review) <br />FEE <br />pnd ���:L%�'"�L�� <br />fo <br />and <br />