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EL.�ECTRICAL PEkMIT APPLIC�TI�N <br />CITY OF EVERETT PERMIT SEi2VICES <br />3200 CEDAR STREET. EVERETT. WA 98201 <br />425-257-8810 - FAX 425-257-�3857 — �riviw.everettwa.urg <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />.J�" i'��- i � ��� �I � � � L�-� - <br />r <br />PROJECTADDRESS <br />� �i )'� � <br />� ���,+� �i ��slt; IR��� � �`i�'� 4iwl� FtU�� �-�C.rC:I-{ �,�,�r1 ����(; I �58 �)���3 <br />OWnef MailAddmss City S�atelZip Phone <br />� � �1:� ,-�� l /�I. i�/�. � �� �� ��U�.`' — _ <br />7enanl MailAddress City Stale/Zip (� Phone <br />� I.�J � <br />J <br />i�l�i;,i _ C._1; �� �;r,...i-� �i���� �'_. �l"( �.�c.,l:<� i?.�"i�h-,.�,.�i�l`�SaJ� ��s�a�-;,,5c(� <br />[lectrical Conitactor Mail Addmss <br />��LL.1lS�`�' / �l�i��) <br />State License Number <br />Proposed Use of Building <br />Descriplion of Work lo Be Done: <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY C1F EVERETT LOCAL SALES TAX CODE IS 3105 <br />.` <br />StalMZip Phone <br />7bLi '� %� � �' <br />Contract Price of Work <br />__ � <br />�r i����l �. Ilui Ltici'�;� <br />Contacl Person (Plan Review) <br />1 hereby certily fhat / have read and examined fhis application and Fnow fhe same fo be Irue and <br />correcl. 411 p�ovis�ons o/laws and ordinances govemmg fhis (ype ol �vork will be completed <br />whefher speafied hcrcin ornaL The gran6ng o(a permrt does notp r�sume to give aufhonty fo <br />violale or cancel the provisions o(any other sfafe oNocal la�v regula(ing construcfion or the <br />perfommnce o( cons6Ucfion. That I am auihonzed by� (he owner olfhis property fo pedorm fhe <br />work (or which applicafion is madc and I romply wifA the Stafr. ConVactors Lnw 1f327 RCW and <br />296.200 WAC. <br />i _ �� <br />�I �i / ; v i��'' +/ "- ��% - �' � <br />rf L D�fe <br />E�lr����� <br />FEE 1 <br />1�� <br />��^�. <br />