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ELECTRLCAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPUCATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ���_� � <br />� `� (� � �%AR �n'1�"2 2 � <br />PROJECT ADDRESS <br />�.'jC'2c5'� �c,��'iac ✓�'r .v�J _ <br />Owner Mail Address <br />Tenant <br />tdail Address <br />Ci1y <br />Cily <br />c <br />L- G'C,�� � -C C 1 <br />StateQip <br />StatelZip <br />Phone <br />Phonc <br />Cl/1/'isOv� No�,+i' ("��'i/'r� lrJc GGLk-/GS`"Si Sc> l.urv.i.�u�oGJA �1,50s% <br />EleclriCal ConlraClor Mail Address Cily � Stale/Zip Phone <br />.? <br />/1�,2a��� ��,�/C�-r' <br />Slale License Number <br />5 r � <br />Proposed Use o( Building <br />Descrip:ion o( Work lo Be Done: (.t% i/L � NC a✓ �-lU�� S� � <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Contract Price o( Work <br />Contact Person (Plan Review) <br />1 hereby certily fhaf I have read and ezanuned this applicafion and know fhe same to Ge frue and <br />correct. All provisions o//a�vs and ordinances goveming fhis type ol �vork will Ge completed <br />�vhefher speciGed herein or noL 7he granting oI a pernut does not presume to give authonty fo <br />violate or cancel the provisions ol any ofher sfale or local la�v regidating consfruchon or fhe <br />peAom�ance o/construclron. That I am aufhurizedby the ownerollhis property to perlorm the <br />work lor which applicafion is maAe and 1 comply with the State Contractors Law i&.27 RCLV and <br />296.200 WAC. <br />� <br />:' !7_ <br />Z-/—D <br />FEE <br />� � _ �; <br />; C'� � <br />C� <br />