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ELECTRICAL PERMI�' APPLIC/�TION <br />CITY OF EVERETT PERMIT S�ERVICES <br />3200 CEDAR STREET, EVERETi�, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everetiwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />`Q`a >�o� <br />� <br />/ � � � /�� � � /1'� vc � Vl �^-.%- � `—� �L � �=�� t'f i �. �.. `j g �" � <br />PROJECT ADDRESS <br />(_C n�i � <br />Owne <br />Tenanl <br />L�a41 i.L.1�.✓ <br />< ( i <br />�,L. `�� /`t� � l' i �� � J t • C <br />t� <br />Atail Address <br />Mail Address <br />.I�C'F✓l/ /"/O—//'f��.0 1/�✓! <br />Eleclrical Conlractor Maii Addross <br />� 1 ������7 <br />Slate License Number <br />�� i� <br />/��'.'..S ,� i 5 . �o c.�.5 �_ <br />Proposed Use of Buildin� <br />Descriplion of Work to �e Done: <br />NOTE: WIRING IN NOfJ-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />� �j� ���c�eus <br />City <br />City <br />-0 ��a.�< �i � <br />City <br />�cl `i�G i �JYI �C��[)�7'.;{-[5 <br />Stale/Zip <br />State/Zip <br />State/Zip <br />Contracl Price o( Work <br />Coniact Person (Plan Review) <br />I hereby certil}� that I have read and exam�ned lhis application and kno�r Ihe same fo be Gue and <br />correcL All provisirns ollaws and ordinances governmg this f}�pe oI work will be completed <br />whelher specd�ed iierein or noL The granting o(a pemuf aoes not presume to give aidYoriry tu <br />violate or cancel the provisions o(any other state orlocal law reguleting construction or the <br />performance ol construction. That 1 am aufhorized by fhe o�vner o/ this property to perlomi the <br />�vork !or which applicatio�is m��de and I comply �tiilh the State Centractors La�v 18.27 RCW and <br />296.200 WAG � <br />z%� <br />FEE <br />'�C),'�- � � /� <br />Phone <br />PLon^ <br />SD %��/%' <br />Phone <br />