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ELECTRIC�L PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org �d _� �O'7 <br />ApPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM L� O%/� IS/ <br />��oy`- 3 �.� � <br />FROJECT ADDRESS <br />� <br />�`_��� , P frni <br />OWnef <br />Tenanl <br />Eleclrical Contractor <br />Stale License Number <br />/�/ ,i i <br />�'{-f' / C t' <br />Proposed Use of Building <br />Dascriplion of Work lo Be Done: <br />Mail Address <br />Mail Address <br />Mail Address <br />�%i�r�� /��/a 9�1'zOf <br />�//f" -S�rif'/ llf��l�=/� S lo� �i7 l s <br />Ci1y Slale/Zio Phone <br />NOTE: \VIRING IN NON-DWE�LINGS IS REQUIRED TO <br />3E IN RAGEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />� <br />City <br />Stale%1ip <br />Cily Slale/'i� <br />F� ���G _ " <br />Cont cl Price o( Work <br />Contact Pnrson (Plan Review) <br />G' ( � <br />il/� i' % <br />I her�by certily Ihat 1 have read and examined this application and kno�.v fhe same lo be true and <br />conect. All provisons ollaws and ordinances governmg fhis type ol work will be completed <br />whether speciGed herein or noL The granting o( a pernut does not presurne to give au�honfy fo <br />violate or cancel the provisions oI any ofher state or 1oc31 law regula;in� construchon or fhe <br />pedonnance o/construc6on. That 1 arn autho�ized by ihe owner o/this property fo per(crm the <br />work (or which application is made and 1 comply wifh the State Contractors Law 18.2' RCW and <br />296.200 WAC. <br />i <br />�� /� <br />,'i��_ � l�?f ' /�/ - Z � - U � <br />Signalure Date <br />FEE <br />Phone <br />Phone <br />���10-�31 <br />