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ELECTRICAL PER�III�' APPLICATION <br /> CITY OF E�'ERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERtTT, lNA 98?01 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICArIONS ARE AC�EPTED FROM 8 AM TO 4 PM <br /> `� I � �- �l �c%r� ��;� <br /> PROJECT ADDRESS <br /> _ S'z5 <br /> ( I �` , �� , ^ �_ ,; , <br /> . )�.,� ,;� �1 �; t7�.,r L . � - r•,, ;i�� �•:��� r I/UF� iblr� > 216 �-:.�1 <br /> . <br /> Ownef Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> i���� �: !. ;'!; _/ <br /> EleclriCal Conlraclor M17ail Address City Statel:ip Phone <br /> Slate License Number C�ntract Price of Work <br /> Proposed Use of Building Contact Person (Plan Revie�v) <br /> Descriptiono(WorkloBeDone: _ � 1 �`- �.< 1 •� r '' -T� `�) ' �� �C (��� / � � %� <br /> J , . . l .. . 1 1 1 ' ' � r <br /> ' i 'l:' ' n ( '. �� •. �. � � �. f �Jii { <br /> � <br /> NOTE: WIRING IN NOPJ-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, A9C OR AC CABLE. <br /> i <br /> I CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 here:�y ceAily Ihat!have read and examined fhis applicafion and kno�v the sa,.��fo 6e Vua ard <br /> ,orrect. All provisions o/la�vs and ordinances govemmg this type o(uork n-ill Ue complefed <br /> whether spea�ed herein or not Tne granting ol a pernut does not�resume fo give authonty fo <br /> violafe or cancel fhe�rovisions olany other stafe orlocallaw regulafing construction or fhe <br /> performance o/consfruclion. Thaf I arn aufhonzed by the ownerolthis properly fo perform the <br /> work lor�vhich application is made and 1 comply�vifh Uie State Contractors La:v 18.27 RCW and <br /> 29G.200 WAC. � � <br /> ' ` � �� CJ -L �5 <br /> i ;�: _� <br /> Signature Date <br />