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ELECTRICAL PEF�M�T APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ' -�!� <br /> L _.� �c /��c:�c ;�� C��e, � f�,f�.�. / i -� <br /> PROJECT ADDRESS <br /> � I � ` <br /> S h .� ,'a..; �l '�w <br /> Ownef W 6 iil Add�ess City State/Zip Phone <br /> �C� �r.i /��•�c-e <br /> Tenanl Mail Address City Slate/Zip Phonc <br /> � cs-L�) <br /> �SS�ci�4 �ri� �i��f.c-,. f� ,�'�x .�P� S.�c���,<<� G1� �,�.��� 33y- i;�'s- <br /> [leclrical Conlraclor A1ail Address City State2ip Phone <br /> p:� <br /> ,�s'Sec�coRFrv� F� 2 `y C. u� -- <br /> S ate License Number Contract Price of ork <br /> �� '\���� / �J.-'.'4�P �J45f <br /> Proposed Use (Building Contacl Person (Plan Review) <br /> � �[ � <br /> Description o(Work to Be Done: .L u�%�H�-.'�i y�� UC i( i?J� �S� /�,�.� j 1.C�;f,�y��,,, �.� <br /> 7--- <br /> �-�� a�y� � ,� a�s� �-�-�,� �;����.c — ��,� �.�, l_k SW; ,�.(., i�.�, <br /> , <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily Ihaf I have read and examined Ihis application and kno�v Ihe same to be frue and <br /> cerrect. All provisions ollaws�nd ordinances governmg fhis lype o/�vork�sill be complefed <br /> �t�hefher speci6ed heiein or noL The�ranting o(a pernut does nol resume fo give aulhority to <br /> violate or cancel the p�ovisions o(any other s(afe orlocal la�v reguPting conswc6on or the <br /> perlormance of consfiuc(ion. Thaf 1 am authorized by the o�vner o/this propeAy to peAnmi fhe <br /> wo�k lor which applicafion is rnade and I cornpty�tiifh the State Confracfors Laa� 18.27 RCW and <br /> 296.200 WAC. <br /> ,'� c �/"< � �W� � �' oz f r' � <br /> �Signature Date <br /> CC�oG^ - 215 <br />