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�LECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-&810 - FAX 425-257-&d57 — www.everettwa.ory <br />APPLICA;'IONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECT ADDRESS <br />i� �l r%q <br />�l�_�- � ZSO/�urriS-�y� �v�>,-e�-7 �gi-22� <br />Own r Mail Address Cily Slale2ip Phone <br />Tenant <br />Electrical Contractor <br />._I�L��9� 3�1� <br />Slale License Number <br />Proposed Use ol .iuilding <br />Mail Address <br />Mail Address <br />City <br />Ci�y <br />State/Zip <br />��/ <br />State2ip <br />Contracl Price of Work <br />Contacl Person (Plan Review) <br />Descri rilon o( Work to Be Done: � <br />I S%4�� Z(�v c4�r�/, ✓//�4iL� /1i/q�F!'— ��l�-ir � <br />�OTE WIRING IN NON-UWELLINGS IS REQUIRED TO <br />4E IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certJy thaf 1 have read anAexamined fhis application and k�io�v fhe sarr.e (0 6e frue and <br />correcf. Al! provisions ol laws and ordinances �overnmg this type oI work will be cornpleted <br />whether sp?cihed he�eii� or noL The �ranting o/a penrnt does nof presunte fo give authonty to <br />violale or cancel the provisions oI any olher state or local law regulafing construction or the <br />perfomiance ol constructron. Thaf I am authorized by fhe o�rner oI fhis property to perlorrn the <br />k�ork lor which applicafion is made and I comply �vilh fhe Slafe Confractors Law 18.27 RCW and <br />29G.200 WAC. <br />� <br />�,'u y� � l(J— �— o i <br />fCsro-o3G� <br />FEE <br />Phonc <br />Phone <br />