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ELECTRlCAL PERIIfIIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />32�� CEDP.i� STREET, EVERETT, WA 96201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEF'TtD FI20M 8 AM TO 4 PM - DEBIT & CRE[?!7 CARDS ARE NOT ACCEPTED <br />��, i � <br />%/�'�/�. ) < ';� �' ��. /� ' <br />/ / ` � �_� _J c. / ��1Lt/ � ,;ii� % . '--!c.�. <br />� , � <br />PROJECT ADCRESS - <br />Owner <br />hlail Atldross <br />� <br />/ ` /;1„ <br />/ <br />Mail .4�dAiess <br />� )? � / �� <br />�' ��L 1 � ; �/ .� i / ��i� i <br />Electncal Contractor Mail Addross <br />, <br />.�.��;' %C' l'i � ��1 � S1� <br />�State License Number � <br />Proposed Use of Building <br />Descnption of Work lo Be Done: <br />City <br />City <br />�✓� <br />Stato2ip <br />Sf IGvL;l//�'!�C <br />SWto2ip <br />C,�.y«�;�% �L// <br />Phono <br />�s',� �y� ' S,, — �� � <br />i� � <br />l Phone <br />� f' 7,�'j � <br />city \ stato2ip .�Z75 '� byn�_3 <br />�c , �, <br />���g �' �� <br />� i.-��, � <br />� Contrad Price of Work <br />/ <br />� �! ,. �. C � Hl/7 <br />Contact Pers n (Plan Review) <br />NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby cert(y fhet I heve iead end exemined this applicafion end know fhe same fo be true end <br />conect. All provisions o/laws end ordinences-governmg fhis type ol work �vill be complefed <br />whefher specified herein or not The granting oI a peimd doe:: nofp resume to give authonty fo <br />violefe nr cancel fhe provisionsal any otherstele orlocalla�r reguleting construchon or fhe <br />perlonnance o/ rnnswctmn. ?het 1 am autNonzed by fhe o�vner of this property to pedorm fhe <br />work lor which applicefion. fs mede end I comply,with th tefe Cantractors Lew 18.27 RCW end <br />�qe �no wac_ - , / i t <br />FEE � <br />� j�' <br />C�� <br />� 4� l�) ���L� <br />�c�5o�o-�13 <br />