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E�EGiRIC,AL PERMIT APP'LICATION <br />CITY OF EWERETT PERMIT SE�VICES <br />3200 CEDAR STREET, EVERElT, WA 9lt201 <br />425-257-&810 - FF X 425-257-8857 — www.evereitwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />,--�"1_ `?-, 13. :' IT !�� .: <br />PROJECT ADDRESS <br />�] A' i �'�l � �� U ii'_> �. e,l :-7 �?S 1 7-�, <br />Owner �dail Address <br />�� <br />Tenant <br />Mail Address <br />(�,V'i�1.�i�� -�r>�fPi� ��'s:�•�,:r`'--- <br />Electrical ConUaclor 1�1ai1 P.ddress <br />Slale License Number <br />Proposed Use of Building <br />� 'I � j��L IZ <� iTi <br />Cily <br />Cily <br />Cily <br />, �l ', �o I '1�'� "'>�i 1 -`l � � i <br />Slafe/Zip Pl�one <br />Slale/Zlp <br />L�� S - `�;�1G <br />Slote!Zip <br />Contracl Price of !�1'ork <br />Conlact Percon (Plan Review) <br />Phone <br />'t��ti' 1 <br />Phone <br />Descriplion o( Work lo Bo Done: G�-� �'« 1�' ``�U ��� �' Z�' `T� ""� �' `�J ��c �N � <br />_�-�.�i->i-� r, � � \b l-=i_ - "frL c �� �>T r��+l-"� $Q<.�iLEK- Qf�N =L_ <br />NOTE: W IRING IN NON-DW ELLINGS IS REQUIRED TO <br />DE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES 7AX CODE IS 3105 <br />I he�eby certily fhat 1 have read and examined fl�is apNlication and kno�v the same fo 6e fruo and <br />conecL All provisions o/laws and or'dinnnces govemmg th�s t}�pe of woiic n�ill be completed <br />�shether specilied herein or nof. The grantin9 0l a permd does nof !�resurne fo give aufhonty to <br />violate or cancel the provisions ol any uther.tafe or local law regul.3ting construciinn or fhe <br />per/ornrence a/consfruction. That 1 am au0to�ized by the owner o� this proper'rv to pedorrn (he <br />woik lor which applicafron is m.ade and 1 compty wilh (he Sfate Contractors La�'v 18.27 RCIh� and <br />296.200 lNA C. <br />`�-. •�,._ � ��\�-tl�� <br />�--�- -_.., <br />FEE <br />�_ <br />��l ll -I Z� <br />