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ELECTRICAL PERMIT AP�'LICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETf, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />n��Jq q 1� <br />� ! :�/ `� !�J ���o, ^ cJ�^ F e c t l ,ti �/�- �/ �L( [ /-r' // <br />PROJECT ADDRESS 7 <br />�,v <«�� l �• � l�� �[j � ;/. G c y y� Y /bo </, /� <br />Ovmer �Mail Address City <br />Tenant <br />Mail <br />Stale/Zip <br />SlateQip <br />�-iy-o� <br />C-o 60 6-o`i/ <br />Phone <br />Phone <br />F�„ {, ^ ��l �7� - �.,, i , ,� y�3 �rs� . ti� c ,a.�„ �, �. �r� 1.%t 9¢� �d <br />Eleclrical Contractor Mail Address City State/Zip Phone <br />Stale License Number <br />!_fii7�ii�P�•ciii� i/�i � r <br />Proposed Use of Building <br />Description of Work lo Be L'nne: !-Iq�/% � �� t �/L G i�'Cr+�r <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />C17Y OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />'! ) Q-� <br />Contracl Price of Work <br />Conlacl Person (Plan Revie�f�) <br />FEF� � <br />�TS �S <br />I hereby certily thal I have read and examined this applicafion and kno�v fhe same fo be true and �QIG �(y - C` � i� <br />conecL All provisions ollaws and ordinances governuig this lype oI �vork will be completed <br />whether specdied herein or not. The oranting o/ a perrnit does not presume to give authority to <br />violate or cancel the provisions of any other state or local law regu/ating construchon or the <br />pe�lonnance o/ construc6on. That 1 am authorized by the owner o( this propeAy to peAorm the <br />work lor which applicafion is made and 1 comply with fhe State Conlractors Law 18.27 RCW and <br />296.200 WAC. <br />—G <br />