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ELECTR�CAL 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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� %Il /-���P,ienc�.c AVfi �6'Ek=Gi� <br />PROJECT ADDRESS <br />\2 ���`� <br />'1f'�i ('c,c�% i7�r Nc�i3�r�o;< a✓� (=d�..e'CTi c,:.� a�5-��7, <br />O�vner Mail Address City � State2ip Phone <br />Tenant <br />Mail Address <br />City <br />Slale/Zip <br />Phone <br />ql✓r!i�tii i�A r��j_ <br />%�lil�ilh'cf I� _-�� �� �Fk'�'i(rj�/NC l�'i.�V A�]U�/CTEt� iYfrl��A�y�/�a 3SS'3GSC <br />Eleclrical Conlraclo� Mail Address Ciry Slale2ip Phone <br />/a� vi��,; ;ES ) 5(: I�S <br />Slale License Number <br />—� <br />� L 5 h � i�: -- i rl � <br />Proposed Use o( E3uildin9 <br />Description of Wark lu Be Done: <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BF IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />��' Ii�.UOCU <br />Contract Price of Work <br />Conlact Person (Plan Review) <br />FEE <br />1 hereby ce�iily lhaf 1 have read and examined fhis applicalion and know the same to be tnie and �_ G� C 3"G'3�' <br />correcL All provisions o/la�vs and ordinances gaverning fhis type o(�vork will be camplefed <br />whefher specified herein or noL The grantinr� ol a permd does not presume fo give authonty fo <br />violate or cancel Ihe provisions o/ any other state or local law regulating construclwn or fhe <br />perfamance olconstruc6on. That 1 am aufhorized by Uie c.vner o/ Bus property fo peAorm the <br />work lor which applicafion is made and 1 comply �vifh fhe Stdte Confracfors Law 18.27 RCW and <br />29G.200 WAC. <br />, 1 �/ , <br />,-,_ �� � . � (_ - ' , �, <br />