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11/20/20�6 Fi9:47 36�655857E h70P,THEP.N LIGHT ELECT FGGE �1 <br />ELECTRiCAL PEF2MiT APPLtCATION <br />CITY OF EV��tETT P�RMIT S�RVIC�S <br />3200 CEDAR STREET, EVCRE7T, WA 98201 <br />425-257-881 G- FAX 425-257-8857 — www.everetlwa.org <br />��..�-n -�6 <br />APPLICATIUNS ARE ACCEPTED FROM U AM TO 4 PM <br />qc�ac� <br />��',=a—e~ / ����I��, t.�c/ <br />PROJECT ADDRESS <br />�v <br />Owner <br />Tenan� <br />%'�c� Y'i'�i �rrr _�i L <br />Elactrical Cuntiacinr J <br />%T „ <br />Ma I AUdre^s <br />fdail AddraSS <br />> <br />A1�il AdJ 0 SG <br />SIatO License Number �" <br />Proposed Vse ot Building <br />Descrip0on of Work to Be Done: <br />U <br />NOTE: WIRING IN NON-DW[LLIfJGS IS RGQUIREp TO <br />BE IN R4CCWAYS, ty1C OR L1C CABLE. <br />C�ry <br />City <br />Cit� <br />SWtelZip <br />SWte/Zlp <br />StatJZip <br />Contmct Pnce of lNoiF: <br />ContaCt Person (Plan Reviewl <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hor�by ceRNy [hot 1 haw reaAand examinod this epplicAtion end hnorv the spme to be fnre ann <br />cur: act. A/l provisions oflaws end urdir�i�nces {�overn�np lhis typH ol worN �rltl be compla(eU <br />wireuier spvcllled hereln or not. The flronflne� u/ a punnrt does nol resume fo c�iva aulhonry to <br />vlolate or cancel the prvvisions of ony ofher stato or focal !aw reguPUng construction or the <br />perlo�munce oI construc(ron. That I em Quthoriied by iho owner of this prupeRy fo nerfom� tho <br />�tirork fo� whicN application is made and 1 comply with the Stote Contracfors Law 18.27 RCW and <br />296.200 WAC. <br />��' -� �1.�� �v a I <br />gnatur�� p�� <br />% <br />Phone <br />Phono <br />Phonc <br />FEE � <br />j5 — <br />,;, � � � l ll� <br />�, <br />