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ELECTRICAL PERMIT APPLICATION <br />EVERETT <br />SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />57-8810 - FAX 425-257-8857 — www.everettwa.org <br />��Z 3 o.s l�i�����1�Sc�,�/ <br />PROJECT ADDRESS <br />���� <br />�J� <br />�YAL�rLJ�A�r"� S'�iN,�IUi .���" ir�A2/?�sc.(l GI� �'�1c'� ��.�'� <br />O�vner MailAddress Cily State/7ip Phone <br />Tenanl <br />Mail Address <br />Ciry <br />State2ip yZ� Phone <br />F�"!-�4�t;��,r'�/Z S'a.0 3��1 G=li A-V Fv %,t�i �5����G/ <br />Eleclrical Conlraclor A1ai� Address City Slate2ip Phone <br />� ���C-!lv'vSS / y.Z L 1� <br />Slate License Number <br />5��� <br />Proposed Use of Building <br />Description o( Wark to De Done: <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 />Contrecl Price o1 Work <br />Contacl Person (Plan Review) <br />:'�1��L <br />1 hereby ceriily flwf ! have read and examined this applicafion and know the same fo be true and <br />corrocL All provisions ollaws and or�dinances governrng this type o( work will be comp/eted <br />�rhether specified herein or noL The granfing ol a pernuf does nof presim�e fo give aufhonty fo <br />violateorcancellhe I�rovisionsolanyofhersfafeorlocallawregulafingconstrucfionorfhe <br />pedonnance oI construction. That 1 am auUionzed by the owner o/ fhis property to peAonn the <br />�vork lor which applicafion is made and 1 compl}� a•ifh fhe Sfafe Confractors Lew 18.27 RC W and <br />29G.200 WAC. <br />� / V�, <br />',�/ /� <br />, j � , .� ,, �_, <� �% � <br />, . <br />Signaturn � . ate <br />FEE <br />3� G G <br />t o���Q, -1�3 <br />