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ELECTRICAL PERiVIIT APPLICATION <br />CITY OF EVERETT PE�MIT SERVI;;ES <br />3200 CEDAR STREET, EVERETT, V!A 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everetlwa.org <br />APPLICATIONS ARE AC�EPTED FROM 8 AM TO 4 PM <br />, �� � � � r�.� � �_ �� <br />PROJECT ADDRESS <br />�� <br />Owner <br />Tenan± <br />Mail Address <br />Mail Address <br />City <br />City <br />State/Zip <br />State/Zip <br />Phone <br />Phone <br />�U !`r� M � r E�-Er_ �-f-�c� V(J�'J ��� i� S� �J 4J j�l f�i l.tl NL1 irJ(� � Z.rl l. y Z J .`�)�i �� S I <br />Eleclrical Conlraclor Mail AAdress Ciry State2ip Phone <br />5�} (`f� �f� � G.. � QAC� �� `, <br />Slate License Number <br />Si � <br />Proposed Use o( Building <br />Description of Work to De Done: _ � E W S� �__ �� �� M�" <br />NOTE' WIRING iN NON-DWELLINGS IS REQUIRED TO <br />BE IN RA�EWAYS, MC OR AC CABLE. <br />CITY OF EVERETf IOCAL SALES TAX CODE IS 3105 <br />Soo� <br />Contract Price o( Work <br />Contact Person (Plan Review) <br />Se?-�+�-C <br />1 hereby certily Ihat 1 heve read and examined this application and know the same to be true and <br />correct. All provisions ollaws and ordinances govemmg tlus t�pe oI work wi116e completed <br />whether speahed herein or noL The granting o/ a pernut does not resume to give aulhor�ty to <br />violafe or cancel Ihe provisions ol any other st,!e or local law reguPting constructron or the <br />pericrmance o/ consfruchcn. Thal I am aufhorized 6y fhe owrier ol this propeRy fo pedorm the <br />worlc Ir�r �vhich applicafion is made and I comply with the State Contracfors Law 18.27 RCW and <br />296.2U0 VVAC. <br />��, _�- ti • L l - 11 � <br />FEE <br />� <br />