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ELECT'?ICAL PERMIT AP''l_ICATION <br />CfTY OF EVERETT PERMiT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 – wv�rN.everettwa.org <br />APPLI:ATIONS ARE ACCEPTED FROM 8 AM TO A PM <br />1 <br />�l � . �� �jy' t c �� � (� � � �� l� ;� �� �-� _ <br />PROJECT ADDRESS <br />�` � / <br />�.��( l�'( % ,��,'!'1 1 r/%Pj{ .�-�i! liiilL-' —/ ��U � <br />Otivr.er Atail AdArr:ss C�ty State2ip Phone <br />Tenant <br />%� % ' L- <br />Eleclrical Conlractor <br />Mail Address <br />tiiail Address <br />Slate License Number <br />Proposed Usa of Ouilding <br />/ % <br />Descriplion of Work to Be Done: 1�%l'LL�//L y� ���i��� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABL6. <br />CITY Of EVERETT LOCAL SALES TAX CODE IS 3105 <br />City <br />Ci[y <br />State2ip <br />Stale/Zip <br />Conlrac� Price of Work <br />Conlact Person (Plan Review) <br />Phone <br />Phane <br />- y,f/� :v c�,t��� � <br />I heieby certily that I hava read and examined this application and know fhe same ro be true and <br />correct All provisions o/laivs and ordinar,ces governing Ihis type o(work will be completed <br />�vhefherspea/ied herein ornoL The gr�nlin� o/a permd does nol presurne to c�ive authonty to <br />violate or cancel the provisions cl any other sfafe or local law regulating consfrucfion or the <br />pedonnance o(construc6on. That I am aufhonzed 6y Ihe o�vner oI fhis property fo peAorm the <br />�vor.k /or which applicafion is made and 1 comply �rith the State Confractors Lau� 7827 RCW and <br />296.200 WAC. ' <br />; I� l ��� C�/ w J� "��� �% � G' S�' — <br />FEE <br />/ <br />�-�-, _ I l�� <br />� <br />