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IELI=CTRiCAL PERM�T APPLICATION <br />C:ITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />�I25-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� ( � � �G1/`�n.R�' '\�. <br />PROJECT ADDRESS <br />e� ?olf C <br />hlail Address <br />Tenanl <br />�l Jn� <br />Eleclrical Conlraclor <br />Slate License Number <br />� �� <br />Proposed Use o( Building <br />Description of Work to Be Done: <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />L �, �' ' `" _"' <br />�/u'. g7o. ��� °t <br />�8�b3 <br />Conlract Price of Work <br />Contact Persen (Plan Reviev:) <br />CITY OF EVCRETT LOCAL SALES T.4X CODE IS 3105 <br />1 hereby certily Qra; I have read and eeamined fhis application and kno�r Ihe same fo be frue and <br />correcL Ail pruvrsions olla�vs and ordinances governm,q fhis rype ol work �vill be completed <br />�vhefher spea6ed herein or noL The c�ranting ola pemuf does not presume lo give aufhority fo <br />violafe or cancel the provisions olany olher stata or local la�v regulating consfruclion or the <br />pe�forntance o(consfruction. That 1 am aidhonzed by tlte ou�ner o/ fhis properiy fo pe�form fhe <br />�vork lor �vhicli applicafion is rnade and I comply with Ihe Sfafe ConVactors Law 18.27 RCW and <br />296.200 WAC. <br />: �\ � � � �. �I �,i�i. ����i ,n , � , � � <br />FEE <br />E�az-v3 � <br />