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ELE(;TRICAL P�RMlT APPLICATIOM <br />CITY OF E=!ERETT PEhMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — wv�rw.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CRE61T CARDS ARE NOT ACCEPTED <br />��(�� ..S.F_. ��e2'l� ON(G( � � J�lr/h �%l TVa���l Cf,� <br />PROJECT ADDRESS <br />OWner <br />Tenant <br />Electncal Contraclor <br />Mail Address <br />Mail 4ddress <br />Mail Address <br />�Uc2 '�5(���lKF <br />Slale License Number <br />��y lt7'1�1/ �1�� <br />Proposed lJke of Duild g <br />Descnption of Work to Be Done: �G- ` � <br />L ; /'i,. � • �/., -i{ <br />Ciry <br />City <br />City <br />Sta1e/Zip <br />SWtelZip <br />y.��• 7 <br />Slate2ip <br />� 1�SU U�1 <br />Contrect Price o( Work <br />Contact Person (Plan Review) <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CAOLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify rhaf 1 have read �nd ezamined this applicafion and knew fhe same to be true and <br />correct. All provisions o/ laws and ordinances governing fhis fype o/ work will be complefed <br />whether speci�ed herein or nnL The granting o/ a permR does not presume to give authonty to <br />violafe or cancel fhe provisions o(any other state or local law regulaling consfruction or fhe <br />peAormance o/construction. That 1 am authonzed by fhe owner o/ fhis property to pedorm the <br />work lor which application is made and 1 comp/y wifh the Sfate Conf2ctors Law i8.27 RCW and <br />296.200 WAC. <br />c <br />Phone <br />Phone <br />Ptwne <br />