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ELEGTRIC�L PEl�MIT APPLICATION <br />CITY OF EVERETT P�RMIT S�RVICES <br />3200 CEDAR STREET, EVEkETT, WA ^:'2C, i <br />425-257-8810 - FAX 425-257-8857 -www.c��.rettwa.org <br />APF'LICATIONS ARE ;�CCEPTED FROM 8 AM YO 4 PM <br />PROJECT ADDRESS <br />`� � �7'-. �' �' <br />C`-U°�c�Y` 1 S <br />j� �'/• :{aS�35.� —b'dc <br />LIG�Iv �ofJ','.ti e }� S.? S — ✓/''f' .Sf ��c'✓�� G� • <br />� <br />Owner Rtail Address City Stale/Zip Phcne <br />Tenant <br />l: �or%� <br />Conlraclor <br />Mall Address <br />i^i c' Lr <br />tdail �ddress <br />ol��{u���- z-� .�g�T � <br />State License Number <br />� <br />�� .r� D�U.-�,a <br />Proposed Use of Build�ng <br />Cily Slate/Zip <br />%��' .5'f/.�1! �I/�. <br />Ci�y Sl'cic/Zip <br />Phone <br />g�'�S1/- oz.��' <br />`�.S'D d ��Go <br />CanU cl Pryice of 14brk <br />� st G/L <br />o?OG - z z�' .i .�/ .% <br />Conlacl Person (Plan Review) <br />Phone <br />Oescription ot VJork lo Oe Done: _�LS��1�< .�l`!!/.�aY � l�l^%�=�,(�� [.c%� ��Ox'7�io.C,�% <br />� Y <br />� i�0 �c i.�o /� Ii��h G�--�? <br />NOTE: WIRING IN NOtJ-DWELLINGS IS REQUIRED TO <br />DE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 heroby certi(y (hat 1 ha��e read and exarnined this application and know the same to be frue and <br />correct. All provlsion.c o(la�vs and ordrnances goveming this type ol work wil/ be cornplefed <br />whefher specilied herein or noL The c�rantinc� o/ a perrnd does not resume fo givo aufhonty to <br />violafe or cance! fhe provisions of any otherstafe or local latv reguPfing construction or fhe <br />performance o/ constn�ction. lhat 1 am authorized by the o�rnaro(this p�operty to perfomi fhe <br />work /or �vhich application is made and 1 comply �vifh the Sfate Contractors Law 18.2� RCW and <br />296.200 INA C. <br />; �C`'Gt���.-�-- �yfzG� � <br />FEE <br />