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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETf, WA 9820! <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />Z/ So7 i?�-'' ,fv�.5t�. <br />PROJECi A�70RESS <br />L /M,� L.FI-r:'je <br />Owner <br />Tenanl <br />Mail Address <br />Mail Addr=ss <br />Cily <br />City <br />Slale2ip <br />State2ip <br />Phone <br />Phone <br />G'/fiZ�S �`Lr�TA�G LGC ?A/9 �A1��[oRo 12D• <�t,c1l59bv�v5 w�r ,�zs� yzf a�9 ��oz <br />Gleclrical Conlrar,tor ldail Addmss City StatelZip Phcne <br />� h`fl �S LS �. q'D 2 DG <br />State License Number <br />��5i f�lnvrt.9Y <br />Proposed Use o( Building <br />Descriplion o( Work lo [3e Cone: <br />b Ir�/ i7�d �L`r <br />NOTE: WIRING IN NON-DWELLINGS IS REOUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Conlract Price of Work <br />ConlaclPerson (Plan Review) <br />1 hereb}� certi(y Ihat 1 have read and exarnined this application and know fhe same to be fruo and <br />correcL All provisiorts o(la�vs and ordinances �a�ernina this type o(�rork n�ill be completed <br />whefhcr specified herain or noL The granfin� o( a permrt dc�s r.ol resume fo give aidhonry to <br />violate or cancel fhe provisions ol any ofher sfate or local la�v re�uPting construcfien or fhe <br />perforrnance o/cons6ucf�on. That 1 am authoiized hy the o�vner o/ this property to perform fhe <br />�vork lor which application is made and 1 compty wi(h the State Contractors La�v 18.27 RCW and <br />296.200 WAC. <br />/ 'GK� <br />/// O <br />FEE <br />l� I (.'C"�- (?L'(,�. <br />