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ELECTRIGAL PERMIT APPLICATIOI'J <br />CITY OF EVERETT PERMIT SER\/ICES <br />3200 CEDAR STREET, EVERETT, WA 98�01 <br />425-257-8810 - FAX425-257-8857–www.everetiwa.org �[•- 3—�"' <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />,=�%1 `J f�{�i ,l o�,J D!r(--� QLA CE <br />PROJECT ADDRESS <br />JE9�P �isiEC���SES <br />Owner Mail Address <br />Ter�ant Mail Address <br />c�,c r��cY��c ���. P.�. e�x ���� <br />Electrical Contraclor Mail Atldress <br />E(sc E 1_-� C� 3 3 �F <br />State License Number <br />��5 t D�=r�� r�t D` t�LE� <br />City <br />Ciry <br />City <br />State/Zip <br />State/Zip <br />/ <br />�s�� wA jQa2�i <br />Stafz�ua <br />Conlract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />— '�S�O�r�'il(<L �iJPL�( <br />Descripi�on of Work to Be Done: ``" �'C !�" l� U N i) L-i�G�200 t� 17 SEi�V I C� <br />- i2� �P =c���=�-s 3 P•�,��6�n�D <br />-- ���� 3 Tv <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certily that I have read and examined fhis apolicaficn and k�,o�v the same to be true and <br />carect. All provisions ollaws and ordinances goveming this f7pe of �vcrk will be completed <br />:vhether speci�ed herein or noL rhe Sranting o/ a permrt does not presume to give authonty fo <br />violate or cancel the provisions of any other state cr loca/ la�v regulating construchon or (he <br />peAormance ol consvuctwn. That / am authonzed by fhe owner �t this property to perform the <br />�vork for whiehaooliwtion is made ar+d�comolv with the State Contractors La�v 18.27 RCW and <br />�'��L^.� � \.2,.-�, <br />� V �_ <br />FEE <br />Phane <br />Phone <br />s�s- <br />Phone <br />`'//-�/� <br />� �� <br />