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ELECTRlCAL PERSVIIT APPLICATIO�V <br />CITY OF EVERETT PERMIT SERVICES <br />3?_00 CEDAR STREET, EVERETT, WA 98201 <br />425-257-R810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />j �'r� �� � �e�'ci � ��.P �� C,t-�ay �'_ _N —��Prefi (,t.�Eq. 9 �w3 <br />PROJECT ADDRESS � <br />(��c�,e✓ �1—��.►� ( yzs) z���-�iz3 <br />Ownef Mail Address City Slate/Zip Pho�e <br />Tenant <br />Mail Address <br />%(e�C'Y L �C'cTric -/3805 llt"f <br />Electrical CoNraclor Mail Address <br />�o�e���re �� 9 �ios _ <br />State License Nwnber <br />Proposed Use af Duilding <br />Description of Work lo Be Done: <br />City <br />,Ur— <br />City <br />/ <br />i ���, h�,� ; � �s-�- <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN P,ACEWAYS, tv1C OR AC CABLE. <br />CITY OF EVEREIT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certily fhat I have read and examined this applic <br />conecL FlII provisions e/laws and ordinances �ovenung <br />whether sneahed herein or noL The gran!ing o( a pernuf <br />fhe <br />WA C. <br />1 <br />Slatc/Zip Phone <br />(,cJ,�- � � z � I _ <br />Stale!Zip Phoae <br />=l� 3,so o= <br />Coniracl Price of Work <br />/i�ft�zri� �zoccc �bo) 6s/�z/9 <br />Conlact Person (Plan Review) <br />n and hnow fhe same to be true and <br />r type ol work will be comp/eled <br />es not resume (o give authonty to <br />v reguPtmg conslrucGon or the <br />mer o/thrs property to peAann fhe <br />te Contractors Law 18.27 RCW and <br />o�f�/�� <br />FEE <br />r <br />1—G� C� � —1 v`C� <br />