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ELEC�'RICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, �NA 98201 <br /> 425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM <br /> II126 �ai„e �i�P,(c� cJ� � <br /> PROJECT ADDRESS <br /> r.� �l �C�o��.� h�n�5�1_.0 /�l�l 11.�`qv� 1d Cuhnwuod wq yBo 3� 206 2Z 6 y�88 <br /> OWner Mail Address iry State2ip Phone <br /> Tenanl Mail Address Ciy SWIe/Zip Phono <br /> l�a►-�c l ��.�-« yD�� S29Z L�,��s w� 9�is� yzs 33s �6 0� <br /> Electrical Conlraclor A7ail Address City State/Zip Phone <br /> vA2N�r.G9)�MG � �- �B� �o <br /> Slate License Number Contract Price of Work <br /> SF2 <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> Description al Worh,�0 6e Done: (�l� /✓�1 �DOB S4 �{- SF�2 �VO A �-r�'iC.� <br /> 6 <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I here6y certily fhaf 1 have read and examined this applicafion and kno�v the same fo be true and <br /> corrocL All provisions ollaws and ordinances�overnmg fh�s fype ol work will be completed <br /> whefher specilied herein or noL Tho granting o/a pernut does not presume fo give authonty to <br /> violate or cancel fho provisions oI any other state or local law regulafing construchon or fhe <br /> perlonnance ol construr.tiof• That 1 am aufhorizeAby the owner ol this properfy to pe�lorm the <br /> work lor n-hich applicafio� .almede a d 1 comply with the State Contractors Law 18.27 P.CW and <br /> 23G.200 WAC. i <br /> � 7-9-OB <br /> Signatu Date <br /> tVbG7 -U75 <br />