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ELECTRiCAL PERIVI�T APPLICATION <br /> CITY OF EVERETI" P�RMET �ERVICES <br /> 3200 CEDAR STREET, EVERETf, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.ev�retlwa.org <br /> APPLICATIONS/1RE ACCEPTED FROM 8 AM TO 4 PM <br /> , � <br /> `��" � f ilP� ��-�z,-� �•Ji��1 <br /> i; <br /> PROJECT ADDRES� �/ <br /> Owner Mail Address Ciry Slale/Zip Phone <br /> ��I-�_�v�-��--- (�c�r�monf V—i!�f cwP <br /> Tenant Mail Address Cny Slale/Zip Phone <br /> �C. <br /> ,.!i ,..'�-.v ..F��� ����,�f�:.til .��}'O . J`,;��1,�,<.,.:; <_ CJ�r %�'J io `/1�-3�Y-/i» <br /> EleCirical ConlraCtor Mail Address Cily Stale/Zip Phone <br /> � � <br /> ��.5 l�C G' L C. 'i;i' h:�� � c�� C:� �_ <br /> Stale License Number Contract Price of Work <br /> I) '' � �/1^� �lJ������J <br /> f <br /> Proposed Use o(Building Conlact Person (Plan Review) <br /> n � <br /> Doscriplion of Work to Oe Done: �� � "�k. �cnr t k r�'�r✓� .S .� ,..� L%C[•_��-� %^� <br /> ( (,1 / <br /> lJ�l'1;. 5:�Y�"1 �S"$ <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIREDTO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. � �^ �O <br /> �l. <br /> u <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certi(y that 1 have read and examined this application and know lhe same fo be frue and i� `Zb� — l� I <br /> correcL All provisions o(la�vs and ordinances governing this type ol worl<will be complefed C <br /> whether specilied herem or noL The granting uI a pernut does not resume to give authonty to <br /> viola(e or cancel tlte provisions o!any other sfafe or local!aw reguPfing consfrucfion or the <br /> perlormance o/consfnicfion. That I am authonzed by the owner o((his property to perform fhe <br /> �vork Ior ivhich applicafion is iriade and 1 comply wifh the State Confrac(ors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � <br /> %���' � ,r%,^ ,(�- _ � �/� 3/ ��- <br /> SignaWre Dal <br />