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ELECTRICAL PERMlT APP'Li�ATION <br />C�TY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, CVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />i I � f�l � ` <br />PROJECT ADDRESS <br />� �-�T�I_I C��_��� <br />ow��� <br />Tenant <br />uw � ��_ <br />Eleclrical Conlrador <br />Slate License Number <br />Use of Building <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />Av� <br />71� No <br />Idail Address <br />Mail Address <br />Mail Address <br />!v= <br />���Y <br />City <br />Clty <br />� <br />��� �i:_,�� V�� <br />Slale2ip <br />StalelZip <br />State/Zip <br />�-fZ5 Z;� �o�.��? <br />Phone <br />Contract Price of Work <br />Contacl Person (Plan Review� <br />Descriplion of Work l0 6c Donc: ' h�l'w �,� Il �Q�� '� �`I O'--(5� iQ �� ��'� v �J <br />NOTE: WIRING IiV NON-DWELLINGS IS F:EQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereGy certily fhat I have read and examined this application ond know the same fo bo frue and <br />correct. All provisions ollaws and ordinances govemin� fhrs type ol work will be completed <br />whether specdied herein ornot The r�rantinr� o(a pernut does not presame fo give aufhonty fo <br />violafe or cancel the provisrons o(an}� ofherstate or local la�v rec�olafing construction or fhe <br />pedonn�nce ol cons(ruction. That 1 am aufhorized Gy the owner of this propert} to pedonn fhe <br />�vork lor which application is rnade and 1 compty �vith the Sfate ConVactors Law 18.27 RCW and <br />296.200 WAC. <br />- �. <br />�__ � . ��. <br />c— �, <br />p'_"��` vc� <br />Phone <br />I�ii7iP; <br />FEE <br />��`�506 -D.�� <br />. . . .�. _ ._. ...__�__ _.�. . � • <br />� . .';:.�e'" � ._..._ �;_, , ,r�_.,.r!% _.._, r,r•e•.,;Y Pr::.�:�� .---.. �'r :r...-. ..�:1rJ. .,:x�.::wh-..._..�.r T•,:�r;y�:`_: <br />