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,.. <br />ELECTRICAL PERMiT APPLIGATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STRE[T, EV�rcE iT, WA 98201 <br />425-257-8810 - FAX 425-257-8357 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTEC FROM 8 AM TO 4 PM <br />/ 7/S n� � l�a,� y� <br />PROJECT ADDRESS <br />OHmer <br />Tenanl <br />Contrector <br />Aue <br />Idail Addmss <br />A1ail Atldress <br />Mnil Address <br />f��I�CI �7�7cL <br />S�ate icense Number <br />5 F lJ <br />ProposeJ Use of Buildina <br />Ciiy <br />CAy <br />Slate/Zip <br />Slate/Zip <br />Phone <br />Phone <br />Lf:1/S�SiL17it^"� <br />O(Z <br />Contract Price of Work <br />Contaci Person (Plan Review) <br />Descriphon of Work to Be Done i� .. NY�.J i� O! � P� ��ln P �4.1 d e tG !. �P. � <br />l�� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 7705 <br />� 1 heroby certily thal I have read and eranuned this application and kno�v (he same fo be tn�e and <br />I conecf All p�owsions olla�vs and ordmances governing fhis type o/ �sork ivdl6e conrpleted <br />� �ahefher speciGed herein ar nof The grantinc� o� a perttnf does nof pre;ume fo give aulhonty fo <br />, VIOI��C 01 CdI1CCI U1C (JIOVISIOl15O� 811y 0iI1Cl SIa](C OIIOC3II8lV I�(Jllla6ng consfn2hon or fhe <br />pc�tnnnOnCe ol Cansl�uCt�ort Thaf 1 am authonzed by the o�vnnr o/ this property �o peAorm the <br />n�ork lor �vhich apphcafion rs made and I comply it�dh fhe Sfate Conlracfors La�v 78.27 RCW and <br />?9G 200 WAC. <br />1Q0�, � y % <br />