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ELECT�:ICAL PERMlT' APPLICQ.TION <br />CITY Or EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-881 D- FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�f9 �`� 27'�` �,�lE vtl E'�l� Gl� 4 g?�3 <br />PF20JECT ADDRESS <br />�l3/,rz.� � • Co ' -� �fR3� 27rN <br />O�mer <br />Tenant <br />6W�� <br />Eledrical Contrador <br />State License Number <br />f-/DI�IE <br />Proposed Use of Building <br />Mail Address <br />MailAddress <br />Mail Addmss <br />vt! <br />��,Y <br />City <br />City <br />Descriplion of Work to Be Done: l��i � w�� you.s� <br />NOTE: WIRING IN N0�!-OWELLINGS IS REQUIRE� TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETI' LOCAL SALES TAX CODE IS 3105 <br />�2 _a �1.�/D <br />C�aia ���� <br />3tete2ip <br />Slete2ip <br />Slate/Zip <br />Contrad Price of Work <br />Conlad Person (Plan Reviewj <br />1 hereby certily fhat ! have read end examined Ihis applicafion and know the same to be true end <br />wrrecf. provisiors ollaws and oNinances goveming Ihis type o! wodc will be complefed <br />whether acdred herein or noL The grpnting o/ a permd does nof �resume to give authonfy to <br />violefo or cancel the provisions o( any other sfale or /ocaf law regu efing consfruchon or fhe <br />perforrnance o( consfrucfion. 7haf 1 am authorizod by fhe owner of thrs properly ro peRo�m 1he <br />work lnr which application is made and I comply wilh Ihe Stale Confractors Low 78.27 RCW and <br />296.200 WAC. <br />~ �;,� �a�� � �f'�e'� /T--��`%� o_ <br />FEE <br />Phone <br />Phone <br />Phcne <br />,i g� <br />12 <br />