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EL�CTRICAL PERMIT APP�ICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVFRETT, WA 98201 <br />425-257-8fi10 - FAX 425•257-9857 — vwvw.everetlwa.org <br />APPLICATIONS ARE ACCFPTED FROM 8 AM TO 4 PM <br />��',� ti .�� /J �, ��C� �4 l <br />PROJECT nDDRESS <br />Owner <br />A1ail Address <br />Cily <br />J <br />Sale/Zip ��� �hone <br />��n�L� �i�S ��'-tc U/ (/Lt�� /J�-zC 1 �'Y/ �J�z <br />Tenant A1ail Address Cily Slate/Zip Phone <br />���� �2S <br />�7 kL A�r i>h'a I-f� t�^i /` 1�/f (/Cdl �l� o� / � l/ •��' � Ii// z f' v�. <br />[leclrical Contraclor tdail Address <br />f7�'(.���/ f'f%'Y1 �/' <br />Slalo License Number <br />�i:.G(✓ <br />Proposed Usc ol <br />Cily � S1ate/Zip Phone <br />/�G `�': <br />Contrac� Price of Work <br />Contact Person (Plan Review� <br />Description of Work to �e Done: -k' ,� v�j�/'� �i� �%�/r / /�lii'� / �'�4/C L�/ �% CN✓����F7 C.�� <br />NOT[: WIRING IN IJON-DWELLINGS IS REQUIRED TO <br />DE W RACE�VAYS, MC OR AC CABLE. <br />CITY O� EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certil}� fhat 1 have read and exarnined fhis applicafion end know fhe same (o be Uue and <br />conecf. All proviswns o! la�rs and ordinances govenung fhis f}�pe of �rork wil/ be complefed <br />whether speci6ed hereirr or noL The �ranfin� of a pernnf d�es nof �resume to c�ive aufhonty fo <br />violafe or cancel fhe provisions o/any ofher stale or local lmti� rec�ul �fing construcfwn or fhe <br />pertonnance ol constn�ction That 1 am autliorized by the o�cner o/ this property fo perlonn fhe <br />�rork lor which application is made and 1 cornpl}� nifh fhe Sfate Centractors Lnw 78 27 RCIN and <br />r-Ee <br />S % �,�. <br />��aL _O%.�. <br />