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( <br />ELECTRICAL PERMIT APl�LIC�4�'IOPJ <br />CI�'Y OF EVERETT PERIVIIT S�R'JICES <br />3200 CEDAR STREET, cVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — �.�ww.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />( iCi � li.,�(�/C, � .r� " �C,1 <br />PROJECT ADDRESS 7 <br />Owner <br />1.1ai1 Address <br />City <br />-9�U1.)i Gl �i �v �.. �/ <br />Tenanl � M�iit Address Gity <br />Address <br />� ��✓ �S� 1%� �� �7 <br />Stalo License Number <br />Propused Use of Building <br />Descripiion o( Work to Be Done: 5,�, i� � <br />NOTE: WIRING IN NON-DVJELLINGS IS REQUIRED TO <br />BE IN RACCWAI'S, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certily fhaf 1 have read r�nd exai <br />correct. All pruvisions olla�vs and ordim <br />�rhether specified herein or noL The gr.: <br />violate or cancel the provisions o( any ol <br />pedormance ol const�ucfion. That I arn <br />�vork lor �vhich applicafion ic ��»�e and 1 <br />296.200 WAC. <br />S�': <br />Ihis applica(ion and Imow fhe <br />govemmg fhis type o( work w <br />�l a pennd does nof �resume <br />ifc orlocal law regu�afing con <br />ized by fhe owner o/ lhis prop <br />}� �vifh the State Contractors l <br />��I� C <br />Stale/Zip <br />Slale/Zip <br />State/Zip <br />�/ —l3 -/t� <br />G icn ;_t� 6�j <br />CoNr�.cl Price of Work <br />Conlacl Person (Plan Revie��•) <br />e to f�e frue and <br />carnpleted <br />�e authority fo <br />lion or the <br />o pe�lomi the <br />8.27 RC W and <br />Phone <br />Phone <br />Phor,� <br />FEE <br />�� <br />j //�D� ' �(.:1� <br />6' <br />