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�LEC�'RICAL PERMl� APPLICATI(�N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - vaww.everett�va.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />��L��� �� ' l.� ` --,_.— <br />�;_ �%ci_ �� / ✓t:���_ Y <br />PROJECT ADDRESS <br />, ,;- <br />Owncr <br />Tenant <br />, �' i <br />��:�, �-:, �.. „ <br />�., <br />R1ail Address <br />Mail Address <br />Eleclrical Conlraclor A1ail Address <br />Slate License Number <br />���� <br />'��/r� <br />- -J ' <br />Propo�ed Use of C3ulkiln9 <br />�escri��lion o� `I� or4, lo Rs Poiw: --.— <br />_, � <br />%l �- .;�-, = J_�'�'"!<�'_ / <br />Cily <br />City <br />Cily <br />` 1 / 1`(� � ; <br />� ".�'in , t � � ��. , .!S � � <br />NOTE: VJIRING IN NON-DWELIINGS IS REQUIRED TO <br />BE IN k/�CEWAYS, MC OR AC CABLE. <br />Stale/Zip <br />Slate/Zip <br />Slale/Zip <br />Conlract Price of Work <br />��5 -- ��33 <br />Phone <br />Phone <br />Fhone <br />Contect Pers� n (Plan Review) <br />CftY OF EVERE7'i LOCAL SALES TAX CODE iS 3105 <br />1 here6y certi/y fhaf I have raad and o,canrineC this application and I<nou� (he same to be true and <br />correcL AI! provisions ol laws and ordinances �overnmg fhis fype of �vork �vill be complefed <br />whefher specified herein or noL The granting o/ a pernut does not resume to give a�dhonty to <br />violafe or cancel the provisions o( any other state orlocalla�v reguPtine� construcfron or tha <br />peiiormance o( consfruc6en. rhat 1 am authonzed by fhe o�vner oI thrs property �� per(orm fhe <br />u�ork (or which applicafion is made and 1 comply with Ihe Sfate Confractors Law 78.27 RCW and <br />296.2110 WAC. � � <br />_:J /���- �/;�/� <br />�..-, ' � "l � t -- <br />r-Ee � <br />�=,_:����� �>> <br />