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ELECT�tICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERE �T, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everattwa.org <br />� S- 5�+�, <br />PROJECT ADDRESS <br />Owner <br />Tenanl <br />APPLICATIONS ARE ACCEPTEC �ROM 8 AM TO 4 PM <br />S`� 5 ' <br />, � <br />Mail Addruss <br />Mail Add« ss <br />City <br />� <br />s�����l+u <br />Slatel7_ip <br />5 - ?z —�':� <br />C G �C' `� - / �'. <br />zs-339-: <br />Phone <br />Phonr. <br />� iv i C I«� ;i ,�. rU��;� �vs� l��o <r:' �tiA igz �� �o-�sY-F�� <br />Eleclrical ConUaclor Mail Aodress City State2ip Phone <br />����( C��—�� �VU �� _ <br />State License Number <br />Jla-1zl.a;� G,��se ��GwK ��cc� �v� <br />Proposed Use ot 3uildinc7 � <br />Description of Work to Be Done: <br />� <br />ii/ �� �l�-� �• <br />L <br />vt.e• z, <br />i <br />oI�P �� �:y,�'' S <br />� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUII�ED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />,� �� <br />CI.J._i <br />Coniracl Price of Work <br />�G�Gi � CCAC'.� <br />Conlact Pcrson (Plan Revie��+) <br />�t � � <br />IUCG <br />1 hereby certily thaf / have read and examined this application and know the same to be true and <br />correct. All prowsions ollaws and ordinances c�ovenung Ihis type o( woik �vi!1 be comp/eted <br />wbeth�� speci�ied herein or not Tl�e �rantin� o( a pemu( does nol resume fo give aufhonty to <br />violate or cancel the provisions oI any ofher state or local law re�uPfing construchon or the <br />pe�formance oI consbuction. Thal I am au(horized b}� the on-ner o! fhis properiy to perfonn fhe <br />wor,t lor which application is n e� and 1 compty �vith the State Coniractors Law 18.27 RCW and <br />29G.200 WA�. �, <br />j i� % /I / / <br />�;c=���� ��' �'�' ,��� S/, �%� _ <br />FEE <br />��� <br />���os -�z�, <br />