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ELECTRI�AL PERMIT APPLICATION <br />CITY (�F EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — �v✓w.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM [�-37 -07 <br />� :1� ' � <br />� �!/� /�, �(�� CJ ��,�rl, r.�.. r����l -'.i� <br />PROJECT ADDRESS <br />�.C4.. � �-�o���c�, �l`%.j�• �,�,��f <br />Tenant <br />1.!ail Address <br />r,i,�i ndd���5 <br />J���<c�occ�.r—c� �,�Ci''� ����`//!Lr <br />�-+. <br />Eleclrical Contraclor Mail Address <br />�1�y��,Lc <br />State License Number <br />��ULJ ���L i l.�'� <br />Proposed Use of Buildinp ' <br />Description of Work to Be Done: �� 7�� `L ` 7�( <br />NOTE: WIRING IN NON-DWELLINGS IS REQJIRED TO <br />BE IN RACEV�'AYS, MC OR AC CABLE. <br />CITY OF EVERETf LOCAL SALES TAX CODE IS 3105 <br />C<.5/cc<<<s <br />Git� <br />Cil� <br />�E:� � c.�-�-� � <br />Cily <br />�o.�SC , <br />G-07�7`lb <br />��'-� %�-�`�v ('l1-���33�1-C+,i3 <br />SlztelZip Fhone <br />Statr!Zip PLonc <br />Stale'Zip <br />Contract Price of Nbrk <br />Conlact Person (Plan Revie�.v) <br />I hereby certily Iha( 1 have read and examined this application and kno�v rhe same fo be true and <br />correcf. All provisions ollaws and ordinances �overning this type ol �vork �vill be cornpleted <br />whefher specdied herein or noL The granting ol a pernnt does nof resume to give authoriry to <br />violafe or cancel fhe provisions olany ofher sfate or lor.al la�v reguPfing consfruction or the <br />perlonnance ol construction. That 1 am aufhorized by fhe owner o! this property to peAorm the <br />work (or which application is made and 1 comply willi the Sfate Contractors La�v 18.2i RCW and <br />296200 WAC. i /I <br />�/� <br />FEE <br />//- � <br />L, <br />�:-����4���y <br />Phone <br />