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ELECTRIC��L PERNi(T APPLICATION <br />CiTY OF EVhRETT PEP,MIT SERVICES <br />3200 CEDAF', STREET, EVERcTI', WA 9II201 <br />425-257-8810 - F'AX 425-257-8II57 — v,hwd.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />, <br />� � <br />l 5C S �v� r��•:t�� ���� ,..;«.d <br />PROJECT ADDRESS <br />D � // / � <br />i/e�i �o��+� ��G`-� S�`�ri�Jli�y�( GJ�Y Z��7��''l� G,J� `��ZvsJ <br />Ovmer Mail Address Ciry State/Zip Phone <br />� <br />�<�J <br />Terant <br />t15M <br />Mail Address <br />���[n <br />l�l[ �I� <br />Ciry <br />Electrical Contractor Sr�Vv��(� Maii Address City <br />��vf:.'lA' / <br />G'�(SU�/Z u5�1tGP`7yYLZ �- ��:� <br />' �� <br />Stale License Number j ('�( <br />�� S�Qu r �cl�t7 <br />Proposed Use of Building� <br />Descriplion of Work lo Be Done� !-i-r, �'''� ��� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TA?( CODE IS 3105 <br />I hereby cedi(y fhat / have read and examined this <br />correcL All provisions o/laws and ordinances gov� <br />�vhether specilied herein or noL The grantin� o(a <br />violate orcancel [he provisions olany othersfate c <br />performance o( censVuction. That I am authorized <br />work for which application is made and I comply w� <br />296.200 WAC. , / / // <br />Slate2ip <br />Stale7_ip <br />Phone <br />�izs ys � - 7�rxJ <br />Phone <br />�iS��� <br />Conlract Price of Work <br />�<^,, [-1, 7Zs 9 s 7 70•�,1 <br />Conlact Person (Plaa Review) <br />i <br />�i.7 �'�'� ���:1`:31 L� c.� ��. <br />and know the same fo be true and <br />ype oI work �vill be completed <br />� not presume to give aufhonty to <br />�egulafing construction or fhe <br />er olihis propeity to perlorm fhe <br />Con(ractors Law 18.27 RCW and <br />y�/.« <br />�, � <br />FEE <br />,, <br />-� � ��_ � ,�s <br />