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ELECTRiCAL PERMIT APPLICATION <br />CITY OF EVERFTT PERMIT SERVICES <br />3200 CEDAR STFtEET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.evereltwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />_ l�a l �°ti��;�,� �,%� <br />PROJECT ADDRESS <br />6 � �( �o�' <br />Eo�o6- v�8' <br />l��(/� <br />�c;� �Oe�� ia�l �.,,,Grez�ti �ti� ��ec�.� W�. � 36a-GS3�/oGS <br />Owner MailAddress Cily SWIe2ip Phone <br />Tenant <br />Mail Address <br />Eleclrical ConUaclor Mail Address <br />n��,Nl�� oa sQ= <br />S�ale License Numher <br />Kes��'ti�e_ <br />Proposed Usc o( Euildin� <br />Ciry <br />Cily <br />Description of Work to Be Done: :�Vj"n ��?�Oi� .tie��:c� <br />NOTE: WIRING IN NON-DWEILINGS IS REQUIRED TO <br />BE IN RACEWAYS, A4C OR AC CABLE. <br />CITY OF EVERETT LOC�L SALES TAX CODE IS 3105 <br />State/Zip <br />2 p,�.t,� 3 , <br />State2ip <br />eS? �/S"o� <br />Contract Price o( Work <br />/'i�,� �ip.C%�i,U.�— <br />Contact Person (Plan Review) <br />1 hereby certily that 1 have read mid examined Ihis applicalion and know U�e same fo be frue and <br />conecf. All provisions o/la�vs and ordinances governu�g fhis t}�pe o/ wo�k wi/l Ge wmpleted <br />whether specdied herein or noL The granting ol a pernut does not presume fo give aufhon;y fo <br />violate or cancel !he provisions ol any other sta(e orlocal law regulating constnrction or fhe <br />pedonnance o! consfrucfion. Thaf 1 am authorized by fhe owner of th�s property fo pedonn fhe <br />work (or �vhich applica(ion is rnade and I comply �riU� the Sfafe Confractors La�v 18.27 RCW and <br />296.200 WAC. <br />FEE <br />Phone <br />�3-9a� <br />Phone <br />� �j�,� <br />� ��� <br />�/ � <br />