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� <br />ELECTRICAL �ERMIT APPLIGATION <br />CITY OF E:�ERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERE fT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />goG �s�� P► �v�1 <br />PROJECTADDRESS <br />a63•�35•34?� <br />T► rn I'�erLC�nGI �-sme_� I aa t 3�+�"� Nu�► CU_.�-b�r y� � t.v� �8� I <br />Owner h'alL�ddress City Slate/Zip Phone <br />Tenant <br />FAail ntltlress <br />ElectricalConiractor nnaiinddress <br />ly1 �F_2.1 O �-� 3 I� SCa <br />State License Number <br />�_� �Vl E- f-C�-YZ'1-1-1 �-I ' Yl <br />Proposed Us of Building � <br />Description of Work to Be Done: <br />CitY Slate/Zip <br />Q�l ldo� h CL�- t <br />Ci1Y Slale/Zip <br />� a��4�ou <br />Conlract Price of Work <br />Contacl Person (Plan Review) <br />0 <br />_ 1;1Y �r�( OLt.S £ C(USSI� G� - - <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES iAX CODE IS 5105 <br />I hmeby certily tlial I have read and exantined lhis application and knav fhe same to be true and <br />carect. All provisions of la�vs and ordinances yovemrng this type of wodr will be complefed <br />whethcr specdied heiein or rwL Tl�e gnnGng oI a pennd does not resume to give aufhonty fo <br />violafe or cancel fhe provisions of any olhei stafe or local law reguPfing constnicfiun or the <br />peiformance o(consVuc6on. That I am authonzed by fhe owner o/(his property fo pedorm fhe <br />work ler which applicafion is rrrade and I comply wi(h fhe Sfa(e Conlracfors La�v 18.27 RCIh' and <br />296.200 WAC. <br />FEE <br />�,r— -- <br />! <br />�>C % <br />