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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 3�� O/O <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �/ 003 v( �� <br />����� 2� ��F �� <br />PROJECT ADDRESS <br />Owner <br />Tenanl <br />tif �E7�,��;T <br />Mail Address <br />Mail Address <br />Eleclrical Conlreclor � nnail Address <br />SU NG fi F; oG� 1-�? <br />State License Numbe,- <br />J �,Q- <br />Proposed Use o( Buildiny <br />Description of Work lo Dc Done: <br />/011� 29 �sv� SE <br />���Y — <br />City <br />roZ26 /�1RrN ,ST <br />City <br />,%GD/ii� ��-�!� i�tiE <br />� /loV.,�T� <br />NOT[: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE �S 3105 <br />�fif - <br />�V�'T �u�OS ,s"37-CP�k <br />Slate/Zip <br />Slale/7.ip <br />��lG W�, �' /! <br />Slalc/Zip <br />ZZS.-� <br />Conlract Price o( Work <br />Phone <br />Phone <br />NyS^ <br />�/�!- 9ia� o <br />Conlacl Person (Plan Reviow) <br />Phone <br />TR/'i/GF.S� lN��iL h'F,.�'!6� <br />1 hereby certif; that I have read nnd examined fhis applicalion and knav tho sanie to be tn�e and <br />correcL All provisions o( laws and ordinances governm� fhis type o( work will be complefed <br />whefher speafied herein or noL The granfing ol a pornut does nof resumo to give aufhonty to <br />violate or cancel 'he provisions o( any other state or local law reguPting consfruction or tha <br />peAormance o( construction. That 1 am authonzed by fhe owner ol this property to per(omi fhe <br />work lor which app1ication is maJe and 1 comply wilh fhe State Crntractors La�v 19.27 RCW and <br />296.200 WAC. / � <br />.�� <br />f��'/l,� � I, �—L�—1 c — <br />FEE <br />/���- ��� <br />