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ELECTRI�CAL �'ERMIT APPLICATION <br />CITY OF EVEFtETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 (f �' =0 > <br />425-257-8810 - FAX 425-257-8857 – www.everettwa.org <br />� 0 7a q�--A <br />APPLICATIbNS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�� Z � V�/ir� ��Se� N �� (1 M71 `�-' �� <br />PROJECT ADDRESS <br />Tw�--Z. —�-wr�''�-t„ <br />Owner <br />Tenant <br />Tm2 <br />Eleclrical <br />Stote License Number <br />�c� nl�"> <br />Proposed Use of Buildinc� <br />?,go7 �-• Lrvl�.c, SAn+� <br />n lc�y N� � <br />Mali ddress <br />Mall Addross <br />2$V7 E• G+�oc stim�^'� <br />��v e1� S� <br />Mail Atltlress <br />Clty <br />City <br />City <br />Slate2lp <br />I.�A-/ <br />Slale/Zip <br />�m <br />S�� — <br />Contracl Price of Work <br />Contact Person (Pian Review) <br />Description of Work to Bo Done: �til-�_ �9 Nr � v�'%t7i41 ✓� Csr,l[L ��l}-%��%L.G{9!"( -h <br />j��TJL{ [.�-+zs �.-v� 1�i�ni �' /Z� /�vEer �t /lJ1AlY,+�/ nia.a � �-An <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 />I heroby certily that 1 have read and examined fhis application and knaw the same to bo truo and <br />correct. All provlslons oflaws and ordinances guveming tliis fypo ol work will be completed <br />whefher speclfied herein or noL The granOng oI a permd does not presume to give authonty to <br />violato orcancel the provisions o/an}� otherstate or locallaw regulating construcfion orthe <br />podomiance o/constn,cflon. That 1 am aufhonzed 6y the owner o(fhis �roperty to perfortn fhe <br />work /or which application is mado ond ! comply wifh tho State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />FEE <br />=BH�s <br />Phone <br />Phone <br />Phone <br />