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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVPRET-r, VVA 98201 <br />425-257-8810 - FAX 425-257-8857 — wNw,everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM S AN TO 4 PM <br />390` NLnt tee, <br />PROJECTADDRESS <br />Owner Mall Address CIry 0 Slate2lp Phone <br />Tenant Mall Address City Stelo/Zip Phone <br />Electrical Contractor Mall Address City Stetsizip Phone <br />C1U rxy-ASS2-2i'?--,kS A2.I o0C7. OU <br />Ststa License Number Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Bo Done: 1� r'� s.bx •- n I U �'�-�� <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />I <br />CITY OF EVERETT LOCAL SALES TAX CO13E IS 3106 -J <br />/ horohy certify that I have read and examined this application and know the same to be tare and <br />correct. All provisions of laws and ordinances governing this type of tvork will be completed <br />whether. spocBied harain or nor. The granting of a perma does not Presume to give authorrty to <br />violate or cancel the provisions or any other state or local law regulatingpconstructlen or the <br />wor�iro orawh ch application rt on is on.ade and l compl k with the'State ContraclorspLaw 18,27 RCW and <br />296,200 WAC. <br />Signalu n � — <br />=off dq-i-3 <br />Z0 39vd lOV SAS 03S NVI06VAD 8Z661bE90ZT 81:L0 L00Z/6Ti60 <br />IN <br />I <br />