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ELE�TRICAL PERIVfIT APPLICATIQN <br /> GIl'Y OF EVERETT PERIVIIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org c�_y _�j� <br /> APPI_ICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ��7�4 "� a� <br /> ��0 / �f�I�l� � <br /> PROJECT ADDRESS <br /> ,�e�,e✓ />r^-vr��s o,� .sl��� - ,.� e-�,� U�� �II���v � _ <br /> Owner ldail Addres� Cily State/Zip PPone <br /> Tenanl MaiIH dress �I �j Cily Slate/Zip Phone <br /> -�4�- � 12�3) � <br /> Electrica�Conlrac�or tdailAddress City Stale/Zip Phone <br /> Slale License Number Contract Price of Work <br /> Proposed Use o(BuiWing Conlacl Pcrson (Plan Review) <br /> Descnption ot Work to ee Done: G�-�//'�-2. �il 'r'��-�� - <br /> NOT[: WIRING IPJ NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> f he�eb certit fhat i have rcad and eaamined this a licafion and know!he same fo be frue and � �' <br /> Y Y PP j_�1G -1 -C�-� <br /> conecL All provisicns of laws ond ordinances govemmg th�s rype ol work�vill be compfeled <br /> whefher specified herein or noL The grantinc�o/a perrmf doe::nof presume to give aulhonty fo <br /> viola(e or cance/the Provisions olany oUier sfate orlocallaw regulnlin,q cons(ruclion or fhe <br /> perlormnnce o/conslnution. That 1 am aufhonzed by fhc avnur o/fhis property fo peAom�the <br /> work lor which application is made and I comply wifh the Stafe Contracfors Law'1D.27 RCW and <br /> 296200 tNAC. <br /> % � <br /> w l; C-�� :_�-;� � � <br /> SignaWre � �al^ <br />