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ELE�TRICAL PERMIT APPLICATION <br />G[TY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREE i', EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — viww.everetivda.org <br />APPLICI,1'IONS ARE ACCEPTED FROM 8 NM TO 4 PM <br />1 Z,iv.S /T � ,�vB. 5 �. <br />PROJECT ADDRESS <br />v?�� d /N►'l./Tf.a�- <br />Owner <br />Tenanl <br />!G LLC <br />Electrical Contraclor <br />G'/fR�S �'L %OZ1�(p <br />State License Number <br />��-srA�i�IT'�tr <br />Proposed Use of Building <br />Idail Address <br />Mail Address <br />C�✓/�G�d I'�t� <br />Mail Address <br />City <br />Cily <br />�rx�sr�cws <br />Cily <br />Descriplion of Work lo Be Done: _�/ I%l� �1�Y✓ ���''� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Stale2ip <br />State2ip <br />StatelZip <br />Contr2ct Price of Work <br />Conlact Pcrson (Plan Review) <br />FcE <br />1 hereby ce�ii(y fhaf I have read and examined Ihis applica(ion and kno�v the same to be frue and ( �- <br />correcL A4 provisions o( laws and ordinances gcvemrng this type of �rod< will bo completed _ ��.V ��(, l, , <br />irhefher sper,ili��l herain or noL The �r�nlin� o( a perrnd does not presume fo give authonly to <br />viola(e or cancel the provisions ol any othe� stafe er local la�v regul<�ting consfruc(ion or the <br />perfom�ance o/constructiai. That 1 am authorized by fhe o�vner o/this property to pedorm the <br />�vork lor wliich applicafion is ntade and I comply irith the Sfate Contracfors La�v 18.27 RCW and <br />29G.200 WAC. <br />Fhone <br />Phonc <br />Phone <br />