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. FAXED OCT 1 U EN1'D <br />ELELTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDf+R STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TA 4 PM <br />,�.� <br />-^� 1 :1 '� �(c'1 � 1" �-�,�'rC.� l- <br />PROJECT ADDRESS <br />Owner <br />Mail <br />City <br />Slale2ip <br />,� -�D-a� <br />L od,o -04� <br />Phone <br />��1'v�., 'fl�1�C.1'�llP (Lu�ltsec� <br />Tenant MailAddress City SlalelZip phone <br />ii�An�,(•,C�fi � Ir('Iti�r�.l((���IY��(�ti;,-, II_e 1('��.-1 1!`-�.���:��,iSi `����,Y�nr���,-1�1•.,ll�l'r>=�t�1�, <br />EIecM I Contraclo� Mail Address Cily StalelZip phone <br />li�� �-� ��iU` ��L' 1LLi�i �i � <br />State License Number <br />:.����r �,L���}�r;�1y�„�r�L, <br />Proposetl"Use of 8uilding <br />Description of Work to Be Done: <br />� � r �. ��-. \ ` � K� �t,U#i�tilW�l <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 />� � 1LL�L' <br />Contract Price of Work <br />Le���r �loU�(�(1`s �13u�1 <br />Contact Person (Plan Review) <br />I hereby certily thaf I Irave read and examined this applicafion and know the same to be truo and <br />correcL All provisions of laws and ordinances govemmg fh�s rype ol work will ba cornpleted <br />whefher speci6ed herein or noL The granting oI a permrt does nut p�esume to give aafhonty to <br />viola(e oi cancel fhe provisions ol any othor sta(e or local law regul,3tmg construction or tfro <br />peAormance ol construchon. That 1 am authonzed 6y the owner ol fbis propeRy to peAorm the <br />work lor which application is made and 1 comply wifh fhe Sfate Conhacrors Law 18.27 RCW and <br />296200 WAC. <br />FEE <br />�17�t0-o�.�' <br />