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ELECTRiCAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everethwaorg <br />� q 3 Z �-i� <br />PROJECT ADDRESS <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO A PM <br />r <br />�f � � /� � .,. �: / Fi /,' rl ( 1�. � : 7 i i � . �� <br />�dail Adtl�ess <br />O�vncr <br />TCnan� Mail Address <br />�_L— �-� I��Svn.) rL��jr��c <br />[leclrical Conlractor Mail Address <br />����lrhl;� � C�Cu �� C <br />Stale Licensc- Nwnber <br />�Y� <br />Propnsed Use of �uildiny <br />Cily <br />Cily <br />Slale!Zip <br />Sla�e/Zip <br />fnlC �.��/�t/(/��o✓j �v� <br />City State�Zip <br />Descriplion of Work lo Be Done: �l �� �v ( F' ( �, �t �� 7 <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />Phone <br />Phone <br />a c�.�� g 7 _ <br />Phane <br />� �; „�, <br />Coniracl Price of Wnrk <br />CoNact Person (Plan Review) <br />us� ;/\�-1 0.'�/T- /"I1�-lr <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby cerLl�� thal l l:�+ve read and exantined fhfs application and know the sarne fo be triie anA <br />correct. Ai! provisions ollaivs and ordinances go��erning this type oI �vork will b� completed <br />whether specilied hcrein or noL The grantinc� ot a pernut does not reswne to give autho�ity to <br />violate or cancel the provisions o( any ofher sfate or local larv reguPfing construction or fhe <br />performance o/ const�uc6on. Thaf 1 am cwthorized Ly Ihe on�ner ol fhis property fo perlorm the <br />work (or �vhich applicafion is made and I comply �vi(h the S(ale Contrnctors Law 1827 RCW and <br />296.200 WAC. <br />n /� � <br />; , l �' )'�:.� `�_ "' 3 - �, �; <br />i �. �.i.�r'.;, / .,:�— — G. <br />FEE <br />._. �C �( � � � �7 <br />