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ELECTRICAL PERMiT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-?_57-8857 — www•everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />y�,�O- � � �� ' �' . GI/ f'�c7T lr�/� <br />PROJECT ADDRESS <br />Owner <br />Mail Address <br />City <br />G --as -09 <br />�� / <br />N1S=.�S�" 1�7� <br />Slate/Zip Phone <br />�,�m� � mL� ���o-��P�, �. C���� w�- �1�y �l�s'JNy-o <br />Tenant Mail Address Ciry StatelZip Phone <br />Eleclrical Contraclor <br />License Number <br />Mail Address <br />QES����- S,�IG�� �M,Ly <br />Proposed Use o( B�ilding <br />City <br />State2ip <br />Con!ract Price of Work <br />Contact Person (Plan Review) <br />Phone <br />DescripiionofWorktoBeDone: �'�I�--(?'� 1� H�U.SC� � I�2L�Jn^ �l,fTG�9R'//�i-l.�µ ��%��� �ti�� <br />�lt o�w k� �hw <br />NOTE: WIRING IN NON-DWELLINGS IS REQU�RED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereGy cerfily fhat I have read and examined this application and know (he same to be true and <br />correcL AI! prowsions o( laws and ordinances qoveming fhis type ol woik will be completed <br />whether specified herein or not The granfing ol a pemnl does not resume fo give aufhonty to <br />violate or cancel fhe provisions ol any other state or local law reguPfing construchon or fhe <br />peAormance ol construchon. Thaf I am authorized by fhe owner ol this propert� ;o peAorm fhe <br />work lor which application is made and I comply with the State Cnnfractors Law 7f 27 RC W and <br />296.200 WAC. <br />Y� <br />ndtUfC <br />FEE <br />��' � / C (�- C`I I <br />