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EL�CTRICAL PERMIT APPLICATION <br />�IT`r OF EVERET"f PERMIT SERVICES <br />3200 CEDAR STREtT, EVERETT, WA 98201 <br />425-257-8810 - �AX 425-257-8857 — www.everetiwa.org <br />APPLICATIONS ARE ACCEPTEO FROM 8 AM TO 4 PM <br />'��' � Gllc.S i � %T��'i'1� �j�-S_ <br />PROJCCT ADDRESS <br />r :��= %CiX <br />owner <br />Tenan[ <br />/�'16;�,; <br />Eleclrical Conlractor <br />Slale License Number <br />Proposed Use of Buildiny <br />.� . <br />, -. <br />U,�;� Nf_ r�, <br />� Mail Address <br />Mail Address <br />Mail Address <br />� � <br />s� � ���, <br />Ciry <br />City <br />City <br />( 'r. <br />`J7= l c' �>� � 2�= <br />State/Zip <br />Stale/Zip <br />State/Zip <br />Contract Price of Work <br />Contact Person (Plan Review) <br />—^ �� <br />Descriplion of Work lo Cie Done: '� r_= lA r� �"'c �-�'�= �—���--� L�ti�r.L Ez<'�.vtii� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RAG=WAYS, MC OR AC CABLE. <br />CI'!Y OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerlily th�t I iiave read and examined this applicafion and know the same lo be Irue and <br />r,onect All pro��isions o//aws and ordinances governmg this type of work will be complefea <br />whether speci6ed hereri or noL The gianting o/a permd does not resume to give authonty to <br />violcvfe or cancel Ihe pr.�visions olany other stafe orlocal la�v reguPting construc6on or the <br />pedorrnance o/construcfion. That I am , ufhorized by fhe owner of Ifus property fo pedorm the <br />u-ork lor which application is made and I cornply with fhe Sfate Contraclors Law 18.2i RCW and <br />29620D WAC. �, <br />o ,' <br />FEE <br />C (i �J L'�I - �l5 L <br />Phone <br />Phone <br />Phone <br />