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ELECTRI�AL PERMIT pPPLICATION <br />CITY OF EVERETT PERMIT SER'JICES <br />3200 CEDAR STREET, EVEREI�', WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.e.verettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />`�l5 /�� �� .�����-- <br />PROJECT ADDRESS <br />� <br />Owner <br />Tenant <br />Eleclrical Conlraclor <br />hlail Addmss <br />A1ail Address <br />Mail Fddress <br />�/'�:v.l� �a Z�� <br />Slate License Number <br />^;' SY�APn,7'�/i-L <br />Proposed Use of Buildiny <br />'%76 <br />City <br />Cily <br />� <br />Cily <br />Descriplion of Work lo Be Done: �' �G/� �'L/I{Ayy{JL <br />NOTE: WIRING IN NOtJ-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />SlatelZip <br />Slale/Zip <br />3 -��ao <br />Cioos-- 0�(9 <br />— 'y�i�- <br />Phone <br />Phone <br />,� g',�,z.�_��_�_y����a�� <br />Stale/Lip phene <br />�s :;.� U <br />Conlracl Price of Work <br />��.r.�����,�,�� <br />Con�act Person (Plan Review) <br />FEE <br />1 herebvi certily fhat I ftave read and examined fhis applrcafion and (<now the same fo be frue and <br />correcL All provisions ol la�vs and ordinances �overning fhis type oI �rork will be cornpfeted <br />�rhelher speci6ed herein or noL The grantinc� o(a pernut does not presume to give authority fo � ��� � ( <br />violafe or cancel Ute provisions o/ any other sfafe or local la�v regulafing conslruction or fhe L���-' J��. � 1 <br />perlcnnance o( construction. That 1 am ��ufhonzed by fhe owner oI this property fo perfomi fhe <br />wodc Ior �vhich application is made and I comply wifh fhe Sfafe Confracfors La�v 18.27 RCVI� and <br />296.200 WAC. <br />a <br />� � � � �%LC �G._''it ���c�/�U <br />