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EL�C�'RICAL PERMIT APPLICATIOIV <br />CITY l�F EVERETT PERMIT SERVICES <br />320Q CEDAR STREET, EVERETT, WA 98201 <br />425-257-8i�10 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FF`OM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />3gO 7 <�P tif �ve�'� l�//� %10/ <br />PROJECT ADDRESS <br />�rorc�on k�l'Kc�ede�'o 380� E <br />Owner Mail Address City <br />Tenant <br />�56 c�%�r, <br />Electrical Contractor <br />Mail Address <br />SS3/ ��1�9� .U�,l <br />GS��(E���3�7" <br />State License Number <br />Proposed Use of Building <br />Description of Work to Be Done: <br />c� ✓�c� W,�l� . <br />Mail Address <br />NC�TE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC QR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CO�E IS 3105 <br />City <br />Ciry <br />St��e/Zip <br />Stale/Zip <br />c,lrg JPz yz <br />SWle2ip <br />Contrect Pnce of Work <br />Phone <br />Phone <br />� 60 <br />,� d Sz_. <br />Phone <br />Contact Person (Plan Review) <br />e s� <br />I hereby certily that / have read and examined this application and know the same to be frue and <br />correct. All provis�ons ol/aws and ordinances govemmg this type o/ work will be comp/eteC <br />whe�her specdied herein or noL 7he granting oI a permrt does not presume to give authonty to <br />violate or cansel the provisions ol any other state or /ocal law regulating construchon or the <br />pedormance ol consrruci�on. That 1 am authonzed by 1he owner ol this property to aedorm the <br />�vork for which application is made anC / �omply with the Sfate Contractors Law 18.27 RCH' and <br />296.200 WAC. � <br />-,%.1���� s-�- o.s— <br />FEE <br />�31 <br />� <br />