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=LECTRICAL PERMIT APPLICATION <br />CITY OF EVEREI'T PERMIT SERVICES <br />3200 CEDAR STRI=ET, EVFRETT, WA 98201 <br />425-257-8810 - FAX 42:i-257-8857 - www.�verettwa.oro / a`3� � <br />APPLICATIONS /lRE ACCEPTED FROM 8 AM TO 4 PM r�ng� _ o�b <br />r I �L l,�/Uc'�L,(-4lit/ J;�i�� �,-- w A <br />PROJECT ADDRESS <br />7�''il�� �`7��5/I�hS �r IZC �[L7Nl1✓S�l� I�UT1f�Li_ (,o <br />Owner A1ail Address Cily SIaINZip <br />Tenant <br />S� L r <br />Eleclrical CoNraclor <br />Slala License Number <br />Use of Building <br />A1ail Adtlress <br />hlail Address <br />City <br />City <br />Stafe2ip <br />State'Zip <br />Contract Price ef Work <br />Cor�act Person (Plan Review) <br />Description of Work to Be Dunc: �- ��# �a �l� �-, �= ,t, �k y N l�j ,Q �iFl /�� i= �'' <br />NOTE: WIRING IN NUN-DW[LLINGS IS REQUIRED TO <br />8E IN RACGWAYS, MC OR AC CABLE. <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 f:ereby ce�iity (hat I have �ead and exarnined Il�is application anAknow the same fo be true and ��� � L�' U 1 `Y <br />correcL All provisiens o/lmvs and r,rdinac�es govemin� Ih�s t}�pe o/ �t•ark nill be cornpleted <br />whether specJied herein or not. The grar.fing o/ a permrt does not resume (o give aulhcnty to <br />violafe orcancel the p�ovisions N any ofher stafe or local law reguP;ing consWcfion or fhe <br />perlorni�nce olconshuction. T��at I am authorized by N�e owner olthis properiy fo perforrn the <br />�vo�k lor ��hich application is made and I cornply wifh the Sfate Contra.;tors Law 18.27 RCW and <br />29G.200 11'4c;. <br />L/ <br />Phone <br />Phone <br />Phonc <br />j , � , <br />_ /--���z .-�c <z�r.�z N� � 3,Z�°�X <br />