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ELECTRICAL PERIV@IT APPLICATION <br /> CITY OF EVEP.ETT PERMIT SERVICES <br /> 3200 CEDAR STREEI', EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —wwv✓.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM � � I S O <br /> .� � <br /> i'�� 1 � ') Y;,'C-'��% //�� i _ I <br /> PROJECT ADDRESFi � <br /> �–.. <br /> i J � <br /> L�� � hi,�/��`,- <br /> O�vnel Mail Address City StatelZip Phone <br /> Tenanl Mail Address City Slale/Zip Phone <br /> Electrical Conlraclor Mail Address City StateiZip Phone I <br /> I <br /> � <br /> Stale License Number Conlracl Price of Work <br /> Proposed Use o(Bui!dinc� Contact Person (Plan Revie�v) <br /> 1 r J� i <br /> � J ��� �/.V�7 � <br /> Description of Work�o Be Done: � �� 0 i <br /> NOTE: WIRING IN hON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETI�LOCAL SALES TAX CODE IS 3105 <br /> I I hereby certi/y Iha(1 have read and examined fhis applica(ion and kno�v the same to be We and <br /> I coriect. All provisions olla�vs and ordinances govemmg this type of work�vill be complefed <br /> �vhefl,er speci�ied herein or noL The granting ola pernut does not presume to give aulhonty to <br /> � violah�or cancel the provisions oI any other state or locai law regulating construc6on or the <br /> � peAqrmance of construction. That I am authorized by the owner o(this properiy to perform the <br /> ��� work lonvhich,application is made and I comply�vith fhe Sfale ConVactors Law 18.27 RCW and <br /> �� 296.2SUWA��: . <br /> �' /� A � �I <br /> .� ����-': / � <br /> — ..� ���-7_�. ,_k �� � ' 7 ' V <br /> -�.Sigi aW � . . � '" " Date <br /> / .i <br /> i CC ?C'�_ .1 ' 7 <br /> � �H'.,;� <br /> Y <br /> +i <br /> �.��v <br /> A:` <br /> ,'�`� <br /> y <br /> �: <br /> hn <br /> �r <br /> ��� <br />