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Nc�v-05-09 10:37A <br />Ii2CUJ <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everetiwa.0rg <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECT ADDRESS <br />li -5 -09 <br />e 09 // --o ),-5 <br />/k <br />Ownnr Mail Address <br />City <br />Statolzip <br />Phone <br />^� <br />Cty <br />Tenant Mall Address <br />Stale/Zip. <br />Phone <br />!� <br />Electrical Contractor Mail Address <br />City <br />State/Zip <br />Phone <br />lib ANf<./Y) i'P <br />Stale Licenso Number <br />(r A- <br />Proposed Use of Building <br />Description of Work to Be Donn: <br />zj <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Contract Price of Work <br />Contact Person (Plan Review) <br />I hereby certify that / havo read and nxemined this application mid I nuw the Sallie to be hue and <br />cnrrncf All provisions of laws and c rdinnn6es govnming this trprr of work will be completer( <br />whelhor spepTied haroin or not. The granting of a permit does nut rmstnlle fo givo aufhonty to <br />viotafe or cancel fire provisions of any offer state or local law, reoul sting ronsfruction or the <br />rk h711elthllrpnwofor which aan. de andI comply u2218.100 WAC. bfrsLaw i87 RCto If rmYad <br />;A. -e- - <br />FEE <br />�CI C`�- <br />