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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />3�'z i n �-r �. w �a►� �v� <br />PROJECT ADDRESS <br />�� a�_o6 <br />C=dGiz—IaJ <br />Owner Mail Address Ciry State2ip Phone <br />Y�S <br />PN���s na� 3��� l�ar�.�.�ar �4� Fc v 9J,�vi >'� 4�ci <br />Tenant MailAddress Cily Slate/Zip ��s. Phone <br />�Y�nc�vukl� J'iI 3�0� Fc�/ �V� Fru ���1 9�'1</ z''`J�/4� <br />Eleclrical Contraclor Mail Address Cily Slale.2ip Phone <br />�i'�.� n�.r�.riYz �� <br />Slate License Number <br />(Gil+�lk ACi.�i <br />Proposed Use o( auildinc� <br />�C�v�J'/bi��uj-i < <br />Description o( Work lo Ce Done: <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC Cr,BLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />3�dou°=' <br />Conlracl Price o( Work <br />Conlact Person (Plan Review) <br />FEE <br />/o ��c <br />1 hereby certily that I have mad and exarnined fhis application and kno�v Ihe sama to 6e true and � p�; ��-� G�j <br />correct All p�avisions o! la�vs and ordinances governmg Ihrs type o( u�ork will be compleled <br />�vhelher specdied herein or noL The �ranting o! a pernut does nof presmne fo �ive aufhoriry to <br />violate o� cancel fhe provisiens of any ofher state or(ocal law regulafing construc!ion or fhe <br />perfcrmance o/ construction. That f am authorized by U�e o�vner oRhis property fo peAonn the <br />�srork lor which application is made and 1 comply �vifh fhe State Contractors Law 70.27 RCW and <br />296.200 WAC. <br />���/r �-� <br />