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ELECTRICAL RERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />320Q 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 />c �/ 3 � DG(CC�'/����� <br />PROJECT ADDRESS <br />C� ��� �� Gt�- <br />�� �� / <br />��3-06 <br />C-c�b o7-00 <br />C.��'l'�Z /`� 2Ltrl� ;�Z' �_ r�' <br />OWnef A1ail.4ddress City SWte/Lp Phonc <br />t' (i <br />Tenant <br />Mail Address <br />Eledrical Contractor Mail Address <br />�,tic�.�l. L L�� 1U jjC� <br />Slate License Number <br />� p h �(` a� L ��-�.._;, t'� :," <br />Proposed Use of �uilding <br />Cily <br />Slate/Zip <br />Phonc <br />n` _�f�L�Z�/%-L�- <br />City Stale2ip • Phon <br />yzS'_Sz,y �3 <br />� 3���Y. o � <br />eNracl P�icc ot Work <br />Contacl Person (Plan Revic�v) <br />Description of Work to Be Done: �� � S� eZ (�.i G, � �.L� �i r-�� — i��c{p.c(' �' <br />Ct C-c.y? 1t arr G'cL�fS' �/ c�.� C�-�' f� -y ��l S` 3'T,.—�Sy w �'t�c"'_� <br />� <br />NOTE: WIRING IN NON-DINELLINGS IS R[QUIRED TO FEE <br />BE IN RACFWAYS, MC OR AC CABLE. <br />' '� '� � <br />� j <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 he�eby certi/y thal I rave read and examineAlhis applica(ion . nd hnou- Ihe sarne to be !n�c and <br />cnnecL All provisions o/la�vs anAordi�mnces goveininc� this type ol �t�orY �vdl be wntpleted <br />�vhefher speci6ed herein or noL The granfing ol a per�nuf does not �resume to give aidhonty to <br />violate or cancel tiie provisions of any olher state or local /aw reguf3ting construcGon or the <br />pe�formance o/ cons6ucGai. Thaf I am aulhoiized by fhe o�vner o(this property fo perfonn 1he <br />work (or �vhich applica(ion is made and I cornply �vifh fhe S(ate Con(ractors La�v 18.27 RCW and <br />29& 20U WAC. <br />i <br />� i <br />�j,e �' ��' � � � � <br />