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ELEGTRICAL PERlVIIT APPLIC�►i l�N <br /> CITY OF EVERETT PERMiT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM _p-�_D S <br /> 1I � y �c� �r u�v+l-f- h7 t cG I,r.�.4-� <br /> PROJECT AD�RESS �- <br /> Owner Mail Address City StatelLp Phonc <br /> si ��j � oun��� . ll zy St- � va..fF �r,¢c� c�,�t-�r ��r-�f 4.� <br /> Tenant Mail Address Ciry State2ip Phone <br /> �tV� <br /> L I'r c � C U 7�{�'U �l:hr.,t�[ o.tJ �C'c�r �Vr�-r !� l.v4- 7 7G '!��3,S J <br /> EleCrical C ttactor Mail AdAress Clly StatelZip Phone <br /> �t',1 1"� JC J QS�L Z <br /> �P IOU. t9c <br /> State License N nber Contrect Price of Work <br /> S�_ `,� S�ttGvL I>La.�rl. <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Descriplion of Work to Be Done: a.C��t L L �Zl < •�f S a� / �D L�'���%✓ S <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> . CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily.haf/have read and examined this application and kno�v fhe sarne to be true and <br /> coriece All provisions ollaws and adinances governmg this type ol�vork�vill be completed <br /> �vhether specilied herein oi noL The granfing ola pennd does not resume lo give authority to <br /> violafe or cancel Ihe provisions o/any olher state or local law reguPfing conshucGon or fhe <br /> per/ormance o(cons(ruction. That 1 am aufhorized by the o�vner of this property to peAorm the <br /> �vork lor which application is made and I comply with the State Confractors La�v 78.27 RCW and <br /> 296.200 WAC <br /> l—� <br /> ! <br /> � Date <br /> casc�; -��3 <br />