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ELECTI�ICAL PERMI� APP�ICATION <br />CITY OF EVERETT PERM17 SERVICES <br />3200 CEDAR STREET, EVERETT', WA 98201 <br />425-257-8810 - FAX 425-257-9857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FRQM 8 AM TO 4 PM <br />�v� S �' �,.� K� r�E�'l,.l L�I.�� <br />PROJECT ADDRESS <br />Owner <br />Ma�l Address <br />Mail Address <br />Cily <br />City <br />State2ip <br />Stale/Zip <br />1 � -�-�a <br />F/o 11..0.3� <br />Phone <br />Phone <br />// � <br />E[����,QI �,Kc ?Sls 7/�A�crl%t /✓%. vcv�,�lc a QR'27� <br />Eleclrical Conlraclor Mail Address City Staterip Phone <br />L-�FGT�c�L- 903 �D a�`AoG-7(3-Y�o97_ <br />�Q3 — C� 3 l'9 - �'{ �'t � 7 Gr U D <br />Stale License Number 7JJ���Z Contract Price of Work <br />Proposed Use of Buiiding <br />Description o( Work lo Be Dono: <br />Conlacl Person (Plan Review) <br />r^ . , r' /� / %% �J <br />,1.� �o w F��- X iT ��' .,� � �, i 1� �P4 L� .a � F C /'cz �,�C.0 /`b L R C <br />���� <br />NOTE: WIRING IN NOIJ-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby cerli(y fhat 1 have read and examined this applica(ion and know fhe same to be Irue and <br />cor�ect. All provisiens of laws and ordinances governing this lype ol worR wi/l be conioleted <br />wh�ther speci6ed herein or noL The granting o/ a pernut does not presume fo give authonty fo <br />violafe orcancel fhe provisions o(any other stafe or locallaw regulating conslruction orfhe <br />per �mance o( constniclion. That 1 am aufhoiized by the owner o(this property to perform fhe <br />wo�k lor which application is mado and l comply �aith the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />FEE <br />2/7 � <br />