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ELECTRICAL PERlVIIT APPLICATIOfv <br /> CITY OF EVEFtETT RERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-Z3857 —wv,nv.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � /l�� T ! //...�'.Yl.:'L!.H v <br /> PROJECT ADDI�ESS <br /> �1 S <br /> r`�E,ra.�G�.f;`cvnyc:%�.r"�e���. 27/7�cz«�Fue�� �L�� J(✓� y'1:.iD/ :� Z/e-,Z1io <br /> Owner Mail Address City Stale/2ip Phone <br /> �y ,f' 4�t j <br /> / 'Vlf+TAi✓�^"c�4cvyA/iC .220 1`tP_� <br /> Tenant Mail Address Cily State/Zip Phone <br /> UNITED ELECTRIC CO I <br /> �lectrical Cortraclor Mai TH SECOND AVf-NUE ci�y ' statc�ZiP Phone <br /> EVERETT, WA 9F�203 <br /> .ti uiTEEc�9��Yc (425) 252•7811 ��/,��— _ <br /> Stale L icense Number Contracl Price of Work <br /> �,4NK <br /> Prop�sed Use of Building Contact Person (Plan Review) <br /> Description o(Work to Oo Dono: ����� r ��F'✓ ��� <br /> NOTE: W:RING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br />� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily(h2f 1 hav�read and�xamined Ihis applical�on and know fhe same fo be true and <br /> correcL All provisions ollaws and ordinances govemm,q(his type ol wod;will be complefed <br /> �vhefher specdieJ Ire�ein or noL The c�ranting o/a pernuf does nof iesume;o give aufhority to <br /> vin.'ale or c3nce/ihe�rovisions of any other sfete or local law reguPfing construcLon or the <br /> pedomiance ol consfrucfion. 7hat I am aulhorized by the owner o/fhis property to parlorm fhe <br /> work lor which application is ma�j d I compty with fhe State Confractors Law 08.27 RCW and <br /> 296.200 WAC. - <br /> ����� <br /> ;�� ,� 22 OC <br /> Signature ata <br /> ���14�0 �- II �o <br />