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ELECTRIC/�L PERIVIIT APPLICATION <br /> CITY OF EVERETT PERMIT S�RVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - F,4X 425-257-8857–www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM - DEBIT& CREDiT CARDS ARE NOT ACCEPTED <br /> �,, ;i } '�_ � <br /> ���:z �� ��� � �'� ��� l�;i-. <br /> PROJECT ADDRESS <br /> -��� -7��� <br /> 0',-�5 //!�'- lt1� ��i%�c� � L L .��� yi /���l����1� S. �✓- ��Y»ou;1c� l���ti ��G� � �L1C' C;�'� ' <br /> Ca�ner �dail Address City State!Zip � Phone <br /> ��/i� <br /> Tenant Mail Address Cih� State/Zip Phone <br /> 1 C� �.�l;/ 7 S' �1 �— ,��,a� � _SC•('c�,�' �i �� I"�.. �Vei'e l/ � ��� �/�i'S ,��->'�'/�� .5 L� <br /> Electrical Conlractor Mail Address City StaleiZip Phone <br /> ���� L�c� �j-�! C�2�3 L L' �� �Sz�c�. �i <br /> Slate License Number Contrect Price of Wo�k ' <br /> Proposed Use of Bui�n� Contact Person (Plzn Review) <br /> Descripiion of Work to Be Done: '�L'� �rn� SC�1�� 1 C �� <br /> l� i� 1 r��:r, �-�r�c�-,� �, 17s�J��,� �. <br /> >(� �� C 'C` <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TG FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ceRi7y fhat 1 have read and examined this application and know the same to be t�ue ard <br /> r,orrecL A:l provisions of laws and ordinances goveming this type o(work�vill be completed <br /> whether specil�ed herein or net. 1he granting of a permrt does not presume to give authonty to <br /> v�olate cr cancel the provisions of any other stale er 1oc21 law regulating construc6on o�the <br /> performance ol construction. That I am authonzed by ihe owner of th�s propeRy to peAo:m the <br /> work/or whi�h apr.!ication i de and I compty•+vith the State Contracfors Law 18.27 RCW and <br /> 296.200 W C. <br /> � � <br /> � . i�. �!�/�� C.� � /_ �J <br /> � .� � lk�— .�' �i <br /> �_� "�,.Y r/ / /��1 { <br /> tl <br /> Signaiure- Date <br /> // �L� � /� v <br /> 4 <br />