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ELE�TRICAL PERMIT APPL��ATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — vnvw.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 ANi TO 4 PM <br />��J�'<< i �t ��(�.._ �� `e ��c�_c�r � .T ����= <br />PROJECT ADDRESS <br />' �.: G-...� 5 <br />Otv C� <br />Tenant <br />� ( Hf�-V ��� _� �( <br />E ectrical Conlractor <br />�'/r( �• S . �. S � � �� / <br />Mail Addrr.ss <br />Mail Address <br />�c:<_ �'%�%/fz: �>, R�� <br />Mail Address <br />lf� l ��/ (_/��i' ( _ <br />State License Number <br />Proposed Use of Building <br />City <br />Cily <br />City <br />/- <br />Description of Work to Be Done: �/ �' �-� ` ` "=� ! ' " � `�� " <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 />/�—/O—O� <br />� o7io-�y5 <br />1� <br />i'a;� (•� l <br />?�� zs 3�5��"�1:� <br />Slate/Zip Phone <br />State2ip Phone <br />StatelZip <br />CoNract Price o( Work <br />Contact Person (Plan Revie�v) <br />FEE <br />I here6y ceRily fhaf 1 have read and examined this applicafion and know the same to be 6ue and <br />conecL All provisions o(la�vs and ordinances governing th�s type o/ �vo�k will be complefed <br />whether specil�ed herein or naL The granting o/ a permd does nof iesume tc give authonty to <br />violate or cancel the provisions olany other sfafe or local lau� reguPting consVuc6on or tlie <br />pe�formance ol consfruchon. That I am authoiized by the owner oI this property to perform the <br />work lor which application is made and I comply with the State Con6acfors La�v 18.27 RCW and <br />296200 WAC. / <br />�ce / � <br />� r <br />i-1�7�G L.��� <br />� ,o; <br />Phone <br />