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ELECT�ICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�l� 3D � �' DR W � �v�r�-�-k <br />PROJECT ADDRESS <br />LC.(,Q�9v�-��.�,�,-�dw�yAvc'PMg'-ksoco�, �vv�-TWa q82o1 �Fa��i3�5z <br />Owne� 61ai1 Address City State2ip Phone <br />Tenant <br />Mail Address <br />City <br />State/Zip <br />Phone <br />�l rn 11 Eler�,r��vinc. 5�iy qs}" Av�1�1E , LlrS4r.�u1S,�A�°14��s9 '�Z5��� <br />Electrical Conlraclor Atail Address Ciry State2ip Phone <br />� Pci�—lJE�S q-1�`Mir <br />Stata License Number <br />SF�z <br />Propased Use o( [3ullding <br />Descriplion of Work to Be Dorn::: �Q..)N�,"7 ?OW e.0 70�__ <br />�--� -- —�-- <br />NOTE: WIRING �N NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1� �,� oe <br />Contract Price of Work <br />Qa\\ �AVI�GUS ��71i3�'�Z <br />Conlacl Person (Plan Review) <br />I hereby certif}� that 1 have read and examined fh.is application and kno�v the same to be true and <br />correct. All provrsions o/laws and ordinances governrng llus type o/ work will be cornpleted <br />whether specibr,d herein or noL The granting o) a pernut does nof resume to give authortly fo <br />violate or cancel thn provisrons o/an}� ofher sfafe or local law roguPfing construction or fhe <br />performance olcorstrucGon. That 1 am aufhorized by the owner ol this proparty fo perlomi fhe <br />work Ior �vhich application is made and I comply �vifh fhe State Contractors Law 18.27 RCW and <br />296.200 WAC. - <br />—��o <br />FEE � <br />