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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SFRVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — r.�ww.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />,� �l�/- �«G�r�e�le�- /jL�t� <br />PROJECT ADDRESS <br />Owner <br />Tenanl <br />r! I.� /`/ � 1.L It �' <br />Mail Address <br />btail Address <br />Conlraclor � Mail Add�ess <br />(�Rt%-NFj97�CL <br />S�ate License umber <br />s F �� <br />Proposed Use o( Building <br />City <br />Cily <br />c�iv <br />StatelZip <br />si�icrz�� <br />�-�s_o$ <br />�D�U ��"�� <br />-� <br />2G6 �b9q-�/ 3 <br />/ 72 <br />Phone <br />Phone <br />cvyy) <br />� 3 yzL- Z 9 SO <br />__ ��,o�,� <br />�� �1i1 <br />Conlracl Price of Work <br />Contact Person �Plan Review) <br />�t n <br />Descriplion o( Work to Be Done: /9 I t� I' 0. i� o h /1 `f" YiAy, 4-+ S �� I' C�C � /�%S G• <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />f3E IN RACEWAYS, MC OR AC CADLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereb}� certily fhat 1 have read anA examined this +ipplicafion and know fhe same fo be true and <br />coner.L All prowsions ollaws and o�Ainances governing this type ol wo�h n�ill be compleled <br />whethc� specilied herein or noL The �ranfing ola pe�md does not resume to give authority fo <br />violafe or cancel the �rovisians ol any olher state orlocal la�r reguPfing construcUon or fhe <br />peAonnance o/ cons�ruc(ion. Thaf 1 am authorized by the o�vner o/ Ihis propr.rty to pedorm the <br />work lor �vhich , pplication is made and I contpty with fhc Sfafe Contractors La�t- 18.27 RCW and <br />296.200 14�A C. <br />� / <br />Sig .— DCJ ���,_�<—�{�- <br />/ <br />FEE <br />�/G� - (�I <br />� z, <br />