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ELECTRICAL PERMIT �PPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8816 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM (.` �a'3 —I'j� <br />�,�Zpu�loS <br />. <br />�� U � 18' �}�-..� u% ur: �- �\ - t o�f <br />PROJECT ADDRESS <br />�o��.cc� La.�a-v��� �i�iol l°dt�� }y-�.��. E�.��e}7 �82o�F <br />Ot^✓ner Mail Address City Stale/Zip Phone <br />Tenanl <br />Mail Address <br />City <br />State/Zip <br />Phone <br />P��-sia . E�i-� c�.ti 223d ,4�.�...�� ,L.� E-��-r�r�n- �1��3 <br />Electrical Contreclor Mail Address City Slale2ip y ZS _2c1�hone <br />�6 30 <br />Q�2Es� E� 9B3 cH <br />Stale License Number <br />SF�. <br />Proposed Use of Builtling <br />Contract Price of Work <br />Conlact Person (Plan Review) <br />Description o( Work to Be Dono: __��a S w�'F�-� c� c� ��ql,� .�' <br />NOTE: WIRING IN NOI�-DWELLINGS IS REQUIRED TO <br />BE IN RACEVJAYS, MC UR. AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 heieby ceRily thaf 1 have raad and examined this application and kno�v the same fo be true and <br />correot. All piovisions o(la�vs and ordinances governing Ihis i}�pe o( work �vill be complefed <br />�vhether specd�ed herein or noL The granting o(a pernut does not presume fo give aulhonty to <br />violate or cancel the provisions ol any other state orlocal law regulating consfruction orthe <br />performance o/construc6on. That I am aidhonzed by the owner of this properfy to pedurm fhe <br />work lor which epplication is made and I comply with (he State Contractors Law 18:27 RCW and <br />296.200 WAC. <br />-i ��4-�. �- ti ._2 3 - <br />si{,nafuro uata <br />FEE <br />� �) CL) <br />� ll �-��-} � 7 <br />