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� <br />ELE�CTRICAL PERMI"� APPLIVATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />4:?5-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />`C�,f�i. l % 9 C� �',!- . C�i <br />PROJECT ADDRESS <br />Go7Ozao2?� <br />//'''1/�C �2 J n�—' �Y U rt'l r' S �� �J jC �. �/ LG �,nN: �'c �f�/� f s'L.S <br />Owner Mail Address Ciry StalelZip Pi�.one <br />Tenant <br />Electrical Conlraclor <br />Slate License Number <br />Proposed Use of Building <br />Mail Address <br />Mail Address <br />City <br />Cily <br />� <br />Description of Work l0 13e Don�: �G i2 T QO�:✓C'� <br />NOTE: W IRING IN NON-DV�'ELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLG. <br />CITY OF EVERcTT LOCAL SALES TAX CODE IS 3105 <br />State/Zip <br />Slale2ip <br />Conlracl Price o( Work <br />Contact Person (Plan Review) <br />1 he�e6y certily that I have read and examined this application and know the same (o be true and <br />cor�ecL All provisions o//aws and ordinances governin� fhis type olwork will be complefed <br />whether specil�ed herein or noL The gran(ing of a penrot does nol �resunte fo give aufhority fo <br />vio/ate or cancel Ihe provisions o/ any o(her sfafe or local la�v regulafing construchon o� the <br />pe�fannance o/ cons6i�ction. Thaf 1 am aulhorized t v fhe o�vner o/ this property to peAo�m fhe <br />wak Ior which applicafion is made and I cornply wifh ihe S(ate Contractors Law 1Q.27 RCW and <br />29G.200 WAC. <br />�' ;1�,��=ti-.— � - �5-- a7 <br />FEE <br />IJ'bTi[� <br />Phoi�� <br />