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�LECTRICAL PERMIT APPLiCATIOAI <br />CITY OF EVEF�ETT PERMIT SERVICES <br />3200 CECAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-b857 — www.everettwa.org <br />,� 7(; �- <br />PROJECT ADDRESS <br />��',l�l,� <br />Owner <br />Tenanl <br />y�.� � <<, i��,r i <br />Electrical Contraclor <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />i rl <br />�t, li Ji �li <br />/'� U ��'I /-= � <br />Mail Address <br />Mnil Address <br />��%� r�- i < <br />Mail Address <br />/!�l � C.� / 1J (- L 0 i) � l.i �-� <br />State License Number <br />s r� <br />Proposed Use oi Building <br />,- <br />Descriplion of Work to Be Done: ��. .%, �� �' <br />, <br />�i-':S� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />City <br />City <br />City <br />Slale/Zip <br />State/Zip <br />State/Zip <br />Co.iUact Price of Work <br />Contact Person (Plan Review) <br />Z L� A �-< <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certily thaf 1 have read and examined this application and know the sarne (0 6e true and <br />correct All provisions o/laws and ordinances goveming this type olwork will be completed <br />whether speafied herein or noL The granfing o/ a pennd does not presurne to give authonty to <br />vio/ate or cancel !he provisions cf eaV ofher sfafe or local law rec�ulafing consfruction or the <br />perlormance ol consVur.6on. That 1 ar� authorized by the owner o/ fhis proper(y to perlorm the <br />work for which upplication is made and I cornply �vith the State Contractors Law 1827 RCW and <br />296.200 WAC. <br />,/ � <br />�//' ,'� �� _��' � � � � ' � - �li � <br />� ' SgYfalure .!" .� Dale <br />FEE <br />� i .��. <br />7 <br />Phone <br />Phone <br />Phone <br />�'V �L V�� — V � � <br />