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ELECTRICAL PERMIT A,PPLICATION <br />CITY OF EVERETT PERMIT SERVICE� <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8610 - FAX 425-257-8857 — www.everettwa.org <br />;2,q I luvl Avc <br />PROJECTADDRESS <br />(1�-13 Su rl;ort. <br />Owner <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />Mail Address <br />Ciry <br />F.vcretl Oral & Maaillofar.ial Surgery ?2291-1oyl Avc l:verett <br />Tenant Mail Address City <br />I'rrlcrrcd I?Icciric 9�2G 2"�2nd Strcet SW I?Jntondti <br />Electrical ConUaclor Mail Address Cily <br />PRI?I�Iili1925P1. <br />Slate License Number <br />SlatelZip Phone <br />wn, ��szoi <br />Stale/Zip Phone <br />WA, 9ti020 20(i.4�X).6691 <br />State2ip Phone <br />�p12.U0Q00 <br />Contrect Pnce of Work <br />I)��ntal Otfim N/A <br />Proposed Use of Building Contact Person (Plan Review) <br />Description o( Work ro Be Done�. I�rmnlitiun, Itr,in, h Cirruit�, I'u�rrr ��nd I i�qhtin}; (nr I)rnlal (/llirr <br />NOTE: WIRING IN NON-DWELL�NGS IS RE(�UIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby ce�iily that I have read and exarnined ffris applicahon and know fhe sarne (o be (rue and <br />correcf. All prov�sions nllaws and ordinances,qovemmg this type ol ivork will be complefed <br />whether specilied herem or nol. The g�an(ing of a permR does not presume to give authonty to <br />wolate or cancel fhe prov ns o/ any o�her state or local law regulating consfruclion or the <br />performance ol consfruc �on That 1 am auflronzed by the owner ol this property ro peAom� (he <br />�voik lor �vhich applica � ��s i aAe and 1 compty with fhe Stafe Con(racfors Law 1827 RCW and <br />296200 WAC. � <br />;�-/y <br />FEE <br />S ?�30.00 <br />C c 9G?-c�6 <br />