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ELECTRICAL PERNiI�' APPLICATIC)�� <br />GITY OF EVERETT PERMlT SERVICES <br />3200 CEDAR STR�_ET, EVERETT, WA 98201 <br />425-257-E810 - FAX 425-257-8857 — www.everett�va.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />7`�,SC% (=.���°;; �rf-, �.�- � <br />?ROJECT ADDREFiS � <br />� �c ..� c,.� �r +; .iC l %C�l�( %.5%�� j�L L�� (��.u�.[�iS I.��� �li����� <br />Owne� � hiail Address City i� StateiZiF Phone <br />Tenant <br />� <br />M2il Address <br />Mail <br />S L'i? �2i'�.�IiC�I' �SSL '> <br />Stat� License Nurnber <br />C Ct�t vl,�tV �' , 4 I <br />Propased Use of Building <br />Desr pliun af Wark to Be Done: <br />' (f_,. � , �� � �� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERE7T LOCAL SALES TAX CODE IS 3105 <br />City <br />Statc2ip <br />Fhone <br />�f-! li/Q r�s<D '> <br />StateiZip Phone <br />l��O -- <br />Conlract Price of Work <br />C/) / �,.�J i f <br />Ll/1 ]`f)Ql��h! �rt.�C-./�!� <br />Conlacl Person (Plan Revie�v) <br />FEE <br />I hereby certily that 1 have read and examined Ihis applir.atinn and know the same to be true and <br />correct All provisions o/laws and ordinances goveming this type oi �vork will6e complated <br />�vhefHer spealied herein crnoL Tl�e �ranting oI a perrnd does not •�resume to give aidhority fo l <br />violate or cancel the provisions o/any ofher state or local la�v regu/ating consfruction orlhe <br />perlormance o(construclioa That 1 am authorized by Ihe owner al fhis propeAy fo perlonn Ihe �!� v <br />work lor �vhich applicafion is made and 1 compty �rifh the Sfate Conlracrors La�v 1 B27 RCW and 1� <br />296.200 WAC. � 1 <br />� � / <br />�% / <br />/���,�1/.lYz!��:'� .�c.'lr. � .S/i,a✓i':c�l�,��J _�i):�7 � <br />