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ELECTRICAL PERMIT ApPLICATION <br />CITY OF EVERETT PERNiIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />�:25-257-£3810 - FAX 425-257-8857 — wwv�.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />'`r>73Z - `�'�' D�Z _ 5� <br />PROJECT ADDRESS <br />.;���3 Av��� (�`I�! Il i''�' n��� JUf� kl�k, r�.�� 9803� <br />Owner Mail Address Ciry Stat�/Zip Phone <br />Tenant <br />Mail Address <br />Cily <br />StalelZip <br />Phone <br />6,P� ;�'��c +�.d.Box (c�c�3 �30�-�.� ���.`i80�11 vz�-v�s <br />Electrical Conlrector Mail Address City Stale/Zip Phone <br />�o ��� i � ����r��= <br />Stale License Number <br />5F� <br />Proposed Use of Building <br />Description o( Work lo Be Done: ��' fJ� �� <br />NOTE: WIRING IN NON-DWELLINGS IS R�QUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Contracl Price of Work <br />Contact Parson (Plan Review) <br />� ( 20 <br />1 he�eby cerYily fhat I have read and examined this application and know fhe sarne to be Uue and <br />conecL All provisions o(laws and ordinances govemmg this type ol work will6e comp/eled <br />wheflrer speciGed herein or nnL The �ranting o( a permrt does nof presume to give authonly to <br />vio'�te or cancel the provisions o/any ofher state orlocal law re[�ulafing co�utrucfion or the <br />perlonnance o/ construction. That I am au(horized by the osvner of Ih�s property to pedonn the <br />�vork Ior which applica(ion is rnade and I compty with the Stafe Contractors Law 18.27 RCW and <br />296200 WAC. <br />�� <br />i� <br />FEE <br />� ol�o�— ���j <br />