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Nov, 3. 2011 11:09AM <br />No. 1451 P. 4 <br />ELECTRICAL PERMIT APPLiCA � ION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERE7T, WA 98201 <br />425-25�-8810 - FAX 425-257•8857 — www.everettwa,org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />P <br />���Ke�e.11P,+'' Ed �q �ZU I <br />PROJECT ADDRESS <br />Owner <br />7enant <br />Eiectrical Contractor <br />��� <br />Mail AddrOSS <br />Mail Addrecs <br />Meil Addtos6 <br />CrnF�CMt-4 qo� f�9 <br />State license NumhEr <br />Proposed Use af Building <br />Descriplion of Work to Be Done� <br />NOTE� WIRING IN NON-DWELl.IN3S IS REOUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE . <br />Gily <br />Gily <br />:V W � <br />Cily <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 9105 <br />� hereby ceRily fhat 1 have read and examined this applica(ion and know fhe <br />correcL All provisions o(faws and ordinances governing fhis rype ol work wi <br />�vhefhe�specilied herein ornoL The pranting ola permd does not resume <br />vio�ate or cancel lbe pro��sions ol any other stnte or focallaw iegu%atinp con <br />pedormance o/conslrucNon. Thof f am authorized by the owner of fhis prop <br />work for �vhi�h applicalion is medg end I compry �vilh !he Stata Confrac(ors L <br />296.200 WAC. <br />i� Q. i`�a.� �� c 1 I� 3� i <br />S(a12/Zip <br />Stale2�p <br />Slalel2ip <br />�I�o3.i 0 <br />Conlract Price of Work <br />Phone <br />Phona <br />25�1 b 6 <br />Phone <br />Contacl Person (Plan Revlew) <br />s to be frue and <br />completed <br />re aufhority to <br />fion or the <br />o perform the <br />8.27 RCW and <br />FEE <br />L \��\-Ga�l <br />