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ELECTRI�CAL PE:RMIT APL�LICATIO�1 <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WFl 98201 S���`�Z <br />425-257-8810 - FAX 425-?_57-8857 — www.everettwa.org �w J Z�a�� <br />APPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM <br />�� � �f ( b�, S�— �,����� w�, �i �� r <br />PFOJECTADDRESS---- --------------------------------------- <br />D -Pj�ux�; ���1( ��c- (,��`i��$L��2�Zz& � <br />�l�v L ���1� �'3��5 <br />a,•,,��, <br />C����,� r�� <br />� <br />Eleclrical Conlrsctor <br />Stale License Number <br />SF� <br />Proposed Use of Buildiny <br />(vtaii nddress City <br />L���► Ie'�"5�-c; e <br />htail Address <br />tvlail Addiess <br />Description of Work lo Be Done: , A��t "� <br />�•,r� �t G�vc ��l�-•"<,(' � .���(!�L <br />-----�_►�__�`�-�-�� __� <br />NOTE: WIRING IN NON-DWELI_INGS IS REQUIRED TO <br />B[ I�! RACEWl�YS, MC OR AC CAl3LE. <br />Cdy <br />Gty <br />Slale2ip 1s\ PLune <br />�,� `i �52� ���1 �� ��?v� �t <br />Stz���Lp Fhen� <br />SlatelZip Phone <br />`�FIDO`�" <br />Conlract Price of VJork <br />Conlact Ferson (Plan Review) <br />�e (7� �'v_1"PiV `i l��L � — <br />CITY OF [VERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certily fhal 1 Irave read and examined Ihis applicafion ard kno�v the same to be frur and <br />correcf. All provisions olla�vs and ordinances goveming this f}�pe o! work �vill be completea <br />�vheiher specified herein o� noL ihe �ranting o/ a pernuf does not ��iesume fo give authordy fo <br />viola(e o� cancel fhe provisions o(any o!her sfafe or local la�v regulabng consfrucfinn or thr <br />performance oI construcfion. That 1 arn aufhorized by Ihe o�rner ol Ihis properiy to pe�fonn �he <br />�rork lor u�liich applicafion is made and I compty �r�fh fhe Slate Cont�actors Law 18.27 RC.V and <br />pn6.200 WAC. <br />'z / 1 ?� <br />FEE � <br />r� � <br />C �2�5- ov) <br />