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ELE�Cl'RICAL PERMIT APPL[CATIOnI <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STP.EET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.evere?twa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� ��� ,� ��� � . ; � <br />: <br />—� � /� J��'t_ �-a. <br />PROJECT ADDRESS <br />L ro/tC-�1 11a nti � <br />Owner <br />Tenant <br />I-��u � r�z ( <br />Electrical Contrector <br />M11ail Address <br />�;1�s S�ttitr�, <br />Ciq, <br />Mall Address Clly <br />/vz�i .4,� � �.��ti � <br />Mail Address <br />If/ht�i Ib�1 � l? �j �3 NI <br />Slate License Nwnber <br />�i r� c �� �l..l I C.Y 1-�i..:�Zi�, N4 <br />Proposed Use af Buildin� <br />Description of Work to �e <br />NOTE: WlRING 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 />City <br />Cf� <br />E7�GE <br />c o��ou�l�s <br />Stale/Zip <br />StalelZip <br />State/Zip <br />� �J <br />� .SZ�(,. <br />Conlracl Price of Work <br />A����,� �lA���nt� <br />Conlact Person (Plan Reviee�) <br />�2�-:3v �� <br />Phcne <br />Phonn <br />'zs377 �y� <br />?hone <br />GtCiKr C'�Q-L 1.�.1Rx K <br />1 hereby certily fhat 1 have read and examined Ihis application and kno�v (he same (o be frue and <br />corroct. Al/ provisions o(laws and ordinances goveming fhis type o! �rork �vill be completed <br />whether specilied herein or not The granting o/a penmf does no( �resumo fo give authonty to <br />violate or cancel the provisions of any ofher stafe or /oca/ /aw re�u�ating construcGon or th.e <br />perlomiance o(construction. That I am authonzed b}� the ou�ner o/ fhis property fo perform the <br />work for which application is made and 1 comply �rith fhe Stafe Confractors La�v 18.27 RCW and <br />29G.200 t1�AC. <br />FEE <br />C �. ? c: �{ I�= S' <br />