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ELE�TIRIGAL PERMIT APPLICATI�N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX425-257-8857-www•everettwa.org �I _ a`�� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM /���I /`D lI <br />�J ` <br />% D� - �a�7" i�� <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />Address <br />Mail Address <br />�� S�/�crn; �-�ov E l�?��,� ST <br />Electriral Contraclor Mail Address <br />(�.' St-�TC�SI-� � 3L� �-I� <br />State License Number <br />Proposed Use of Building <br />Uescription of Work to Be Done: ��� �� '^' <br />f�lr����+� T��1lC�-�sS 11,11h-7'e,�- <br />NOTE: WIRING IN NON-DWELLINGS IS RE�IUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Cily <br />Ciry <br />StatelZip <br />(bl��Z <br />Slate/Zip <br />� 3�5.— <br />Contracl Price of Work <br />Contact Person (Plan Review) <br />c�rz��x,— r-o2 �s�� <br />1 hereby certify that 1 have read and examined this application and know fhe same to be true and <br />correcf. All provisions of laws and ordinances goveming this fype of work will be. completed <br />whether spea6ed herein or noL The granhng of a permd does nof presume lo give authonty to <br />vio/ate or cancel the provisions ol any other state or local law regulating consfruction or the <br />peAormance of construchon. Thaf I am authonzed, by the owner o( lhis property to peAorm the <br />work for which appl:cation is made and 1 comply wdh the State Contractors Law 1827 RCW and <br />296.200 WAC. <br />FEE <br />�'- ��-`�'j <br />Phone <br />Phone <br />736� <br />Phone <br />