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ELECTRICAL PERMIT' APRLICATION <br />Cll'Y O� EVERETT FERMIT S�RVICES <br />3200 CEDAR STREET, EVERFTT', WA 93201 �— S—/O <br />425-257-8810 - FAX 425-257-885% — www.everettwa.org ���U � p�?� <br />APPLICATIO`.JS ARE ACCEPTED FROM 8 AM TO 4 PM <br />=,� l l`I' ��i C i �� �'C <br />� <br />P ROJ ECT AD D RESS <br />Owner <br />Mail Address <br />Cily <br />State/Zip <br />Phone <br />:'��, �tili-l�r /l�.rit�' — <br />Tonanl Mail Address Ci1y State/Zip Phone <br />a r,� <br />L�z���v r' _ �-f,_ <br />� <br />�nt�� i���� ijcx 7ym ��Ext��i" ivi-� ��Zi3 z5z �G� <br />i F- E�-F <br />Electrical Conlraclor Mail Address Ciry State/Zip Phcne <br />�: �-��u1 �t I �'�;>� '� <br />Stale License Number <br />Proposed Use of Buiiding <br />Description of Work to �e �one: _ L ��� F{ i iN(_� �C�c�DLf'f� <br />NOT�: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AG CADLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />��00 m <br />Conlract Price of Work <br />Contact Person (Plan Review) <br />I hereby certi�y fhat I havo read and examined this applic.ilion and know fl;e same lo be frue and <br />correcL All provisions of laws and ordinances goveming fhis type ol �vork wi116o complefed <br />�vhether specified l;erein or not The �ranfinc� of a pennd does nof resume to give aufhonly to <br />violate or cancel fhe provisions o(any other state or/or.alln�v re�uPting cons(rucfion or fhe <br />pedomiance ol construclion. That 1 am aufhorized by the owner ollhis property to peifurrn (he <br />�vork /or which application is rnado and 1 compl}� �vifh Ihe Sfate Confracfors La�v 18.27 RCN� and <br />29fi.200 WAC. , <br />� --� /. <br />.�17(ti �: . G;./J'/t� <br />FE[ <br />%J'C <br />'� � UQ � - C3:i <br />