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ELECTRICAL PERI�„?' APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETi', WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE. ACCEPTED FROM 8 AM TO 4 PM <br />�}�J(7 �V�i f-V�'i�� )�I�.l, Ini(��( <br />PROJECT ADDRESS <br />.,i.it,n, � <br />J1�iS �; ; � , ; ,� l2r�l ��Nn���N � 1-a�,s6� - 4���r�E 1 +� 961y� _ <br />Owne� Mail Address City Slate/Zip Phone <br />RN�No ��r��� � ti�n �.��� ��r��r-r ✓�nii Gda� �2�iT �1A- SPzc�, <br />Tenant Mail Address City Slate/Zip Phone <br />l7Sinu�/C n1RyiA�IC%i 1NC 21711�i 4GTN/�� GL�- I%%a �v�Z/�kG %L %t�� �04'�� �2h`-77y-£�'�I ( <br />Eledrical Contractor Mail Address Ciry State/Zip Phone <br />c��.�l�l�Mi ��)'ZJ�� <br />Slale License Number <br />Tl�l� C �� '�E-n i I �11�i'-`� / C/b1r1�Fi i2C��/-i'L <br />Proposed Use of Building <br />Descriplion of Work lo Be Done: <br />Contrecl Price of Work <br />Conlact Person (Plan Review) <br />� ��� /h% �<t�U�,� �f��'C!'rtF1�1t=��"1- (� l�A�+-ti('it+'� "F Ui?LIzINC-� <br />� Y �� A Iv �C -� ra� i� ��J� �-r �- l�z.R�- il1{i�6'� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERE'fT LOCAL SALES TAX CODE IS 3105 <br />1 hereby cerfi(y that 1 have read and examined tliis application and kno�v fhe sarne (o be true and <br />correcf. All provisions of laws and ordinances 9ovemin� this type o( work will be complated <br />�vhelher specilied herein or not. The grantinc� ol a pernut does nol resume to give aufhority to <br />viola(e or cancel fhe provisions of any other sfate or local latv reguPating construc(ion or fhe <br />performance o/ construclion. Thaf 1 am authorized by the owner of this property to perfonn the <br />work lor �vhich application is made and 1 comply �+�i;h fhe State Contracfors Law 18.27 RC W and <br />29G.200 WAC. <br />a,-, - <br />FEE <br />�1112 - 05�z <br />