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ELEI;TRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVEREI-f, WA 98201 <br />425-257-8810 - F?,X 425-257-8857 — vrv✓w.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />i 3 0 3 �i/ir%,:P, �,.,� ; A„w <br />PROJECT ADDRESS <br />Owner <br />I �i0�i !�.o-.ir�u.as, <br />Mail Address <br />�d.:..�� �Ltit <br />City Slale/Zip <br />'r-�� —vd' <br />C. G� �c'3 _05 <br />5`zS— <br />75z-yc-�is <br />Phone <br />Tenanl Mail Address Cily Slate/Zip Phone <br />.�� Eo,U:•�4� ��:,� � G� � z��o ,� /�.,.��� i �v�ir �i- 9azo i <br />Eleclrical Contraclo� Mail Address City Stale2ip Phone <br />/PJ fb It1 i� i7i (i `=l l7 �. � <br />Stale License Number <br />%�7�VL�Q <br />Proposed Use of Building <br />Descriplion of Work to Be Done: <br />NOTE: WIRING IN NON-DWELLINGS IS R�=QUIRED TO <br />BE IN R4CEWAYS, MC ORAC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />�-J v v <br />Contract Price of Work <br />Contact Person (Plan Review) <br />1 hereby certily that I hare read and exanineU tHis applicalion and know fhe same fo be true and <br />correcL All provisions olla�vs and ordinances gevemmg this type of work will be complefed <br />whether specilied herein or noL The c�ranting o/ a pernut does nof resurne fo give authonty to <br />violafe or cancel the provisions o(any other state orlocal la�v reguPfing consWction or fhe <br />pe.dorm�nce olconstruchon. That I am aufhonzed by the o�vner o/Ihis property to perfomi fhe <br />�ro�k lor which applicalion is made and 1 cornply with liie Stafe Confractors Laiv 18.27 RCW and <br />296.200 WAC. <br />i <br />i ' <br />1'YSr.�' 'h.%f" �� il �� <br />FEE <br />� .��J <br />�u�C1�. <br />