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E�ECTRICAL p�RMl�' APPLICATION <br />CITY QF EVERE7T P�RMIT SERVlCE� <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-25?-8810 - FAX 425-257-8857 — ww�,v.everettwa.org <br />I`%�'� SC r� <br />PROJECT ADDRESS <br />Uwner <br />�ft ✓1GI �4 <br />Tenanl <br />APPLIi.ATION5 ARE ACCEPTED FROM 8 AM TO 4 PM <br />r,,zfi l�l��Ir b,z. <br />�vtail Address <br />Mail Addrass <br />5�:.�G4i , I � ��c�-;.� �.,c. <br />Eleclrical Contraclor Mail Address <br />� /[ �: <br />�� L� ��� i� � ,� L G' � l-- <br />State License Number <br />Ciry <br />Cit, <br />Statr,2ip <br />State/Zip <br />�✓ /" <br />Stale/Zip <br />ii � <br />J � /'; �1 � I <br />Contract Price o( WorY, <br />Phone <br />Phouc <br />-, , � b <br />c'G'G �� Ti C ', � <br />Phone <br />Proposed Use of Building Conlact Person (Plan Review) <br />/ � <br />DescripUon o( Work to Bo Done: L( c c�'� ��� �� � �\,; � c� l� �� ..� � ii .�, � �, �� f-, .� :, l .I.; S y� c z� ��_ C��. �!. S <br />�, r ,�.v, , <br />NOTE: W�RING IN NON-DWELLINGS IS REQ!JIRED TO <br />BE IN RACE\NAYS, MC OR AC CABLE. <br />CITY OF tVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certily fhaf 1 have read and exarnir.ed tHis applicafion and kno�v the same to be Vue and <br />correcL AI( provisions olla�vs and ordinances yoveming fhis type oI �rork �vill Ge complefed <br />�vhelher specilied herein or not The granfing ot a pernut does not resume rp give authorrty to <br />violate orcanccl the provisions ol any ofher stafe or local la�v reguPting construction or the <br />perfomiance o! construcfion. That 1 em autl�onzed 6y fhe o�vner o( this property to perfonn the <br />!vork for which applicafion is rnade and 1 comply wifh fhe Stafe Confracfors La�v 18.27 RCW and <br />296.200 WAC. <br />� � �, <br />!_� � '�— <br />� <br />� �. � <br />'% /' � <br />� � i � Ij /(. � . <br />FEE <br />r�o�`G`�q <br />