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ELEGTRIrAL PF_RMIT APPLiCATIOf� <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEUAR 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 - DEBIT & CRE�IT CARDS ARE NOT ACCEt�TED <br />� �'i02-, S� �ver�-ti- mp�il u�1a� <br />PROJECT ADI�RESS <br />oW��� <br />Tenant <br />� � V�CJ G.1 CLI K/ L <br />Electrical Contraclor <br />� <br />Mail Address <br />Mail Address <br />Mail Address <br />J(�DD � 2��✓no <br />Slate License Number <br />Q�-�A t I <br />Proposed Use of Building <br />Descriplion of �Nork to Be Done: <br />Ciiy <br />�«� E <br />Cily <br />S�. � <br />Ci�y <br />NOTE: WIRING IN NON-DNIELLINGS IS REQUIRED TO <br />BE IN RACEV�,'AYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />State/Zip <br />Stale/Zip <br />StatelZip <br />C,S� 6G <br />Conlracl Price of Work <br />Contact Person (Plan Revicw) <br />2 X <br />I heie6y certity that 1 have read and examineo this application and knu�v the same to Ge true and <br />correct. All provisions of laws and ordinances govenimg this type ol woik will be cornpleted <br />whether spealied herein or not The granting of a permit does not presumz to c�ive authonty to <br />violate or cancel !he piovisions o� any other state or local law regulatin� consfruction or the <br />performance oI consfruction. ; hat I am authorized by the owner of fh�s prcperty to perfonn the <br />�vork Ior which applicafion is rnade and I comply with the Stafe Contractors Law 18.27 RCW and <br />FEE <br />�CJ "�' �'' / <br />.__�'v /' �% / <br />Phonc <br />Phone <br />Phone <br />