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ELECT.P.I�AL PERMIT APPLICATION <br />CITY UF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everett��a.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �„ _ o a-ob <br />.Z�D� �/A/Z b�ScN av .�t� � ��L <br />PROJECT ADDRESS � <br />� k I h� y�� .:T/N <br />Ow�Cf A1ail AJdiess Ciiy <br />Tenant <br />A1ail Address <br />City <br />Slate/Zip <br />State2ip <br />Phone <br />Phone <br />1.�����l��i ��y-��v �i�,-r Av€ � �v �-�d� u,�1 w� ��a�.� <br />Elechical Conlractor Mail Address Ciry S�ale/Zip Phone <br />�-� � =p�,l �ik[ <br />State License Number <br />/�Zt` 7/J lL. <br />Proposed Use af B ilding <br />�,s� <br />Contract Price o( Work <br />Conlacl Person (Plan Review) <br />Descriplion of Work lo Be Done: �Z�� �/' /IG'�G -f- C�/%• �(%�[ c/. <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 />1 hereby certily Ihat I have read and examined fhis application and hnou� the same fo be we and <br />conecL All provisions o(laws and ordinances govemine� Ihis type ol worF u�ill be comple(ed <br />�vhefher spealied herein or not The grantin� o/ a perrnR does not resume (o give au(1 onty fo <br />violafe or cancel the provisions o(any other sfate or focal law reguPting consVucGon or the <br />pedom�mice o( construcfion. Thaf 1 am aufhonzed 6y the owner o/ tius prope�l}� to perl� mi Ihe <br />�aork !or which applrcafion is nmdc and 1 compty �vifh the Stafe ConU �ctors Law 78.27 F C W and <br />79G.200 WAC. � .1 <br />/% <br />G`'C� <br />FEE <br />