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ELECTlR6GAL PERMIT �4PPLICATION <br />CITY OF EVERETT FERMIT SERVICES <br />3200 CEDAR STREET, EVERETl�, WA 98201 <br />425-257-a810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 RM TO 4 PM g_ �(.` �U <br />, - � �.. ! t / �. �," ;v�. <br />� `_% :; l -. I /-� � c ( _ c. �„ � r � � 1 �_ = �� <br />PROJECT ADDRESS <br />> <br />`_� <br />Owner <br />7enant <br />�. 5,L •�l� ���� <br />P,1ail Address <br />Mail Address <br />City <br />City <br />� �%�,; ,� ; ,! �;'�,i�- ->:_�� �._v� 4 <br />,. r, :� i"r 'I/i�. <br />Eleclrical Conlraclor � Mail Address City <br />� ��- , <br />� ( i 1L">i��I <br />Slate License Number <br />%i , � : <br />Proposed Use of Building` <br />Description of VVork to Be Done: ��� S ��`-�` `-`� `-�" '�" f� i �� �`� �^ -� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />c�o�os-ii3 <br />%�i.>;�" ;���:;3•1-c�1-= <br />State/Zip <br />State/Zip <br />Stale/Zip <br />Phone <br />Phone <br />G ;11;, ;�� 7� ;4 <br />Phane <br />Contracl Price of Work <br />Contact Person (Plan RevieH�) <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby cerfil}� that 1 have read dmd examined Ihis applicafion and know Ihe same to be t�ue and <br />correcL All piovisions ollmvs and erdinances �overnina fhis f}�pe olwork tvill be completed <br />whether speci6ed herein or noL The granting of a pernuf does nof resume fo give aufhordy to <br />violate or cancel the provisions o�any other sfafe erlocal law reguPting constructiai or the <br />peAorniance of construct�on. That 1 arn aufhorized by the owner of this properiy fo perfonn the <br />wcrk lor which application is made and 1 comply �vith fhe Sfate Confractors Law 1827 RCW and <br />296.200 WAC. ' <br />i <br />'/ � <br />� _i �� �` _� � _ /�, � <br />FEE <br />!c o-7a-� � �i� <br />