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'; ELECTRICAL P, :RMIT APPLiGATION <br />; CITY OF EVERETT PcRMIT SERVICES <br />I �20C CEDAR STREET, EVERETT, WA 98201 <br />�325-157-A,810 - FAX �2F-257-8857 - �+w�.v.everettwa.org <br />IAPPUG>TIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARUS ARE NOT ACCEPTED <br />�— - ---- <br />� <br />J�. ,�. , - ,� � � .�-�� <br />� � .; ' � , , � ,. c ,,. �c� r� :.� _� _� <br />PROJECT ADDRESS <br />l �``1 <br />Owner <br />Tenant <br />/ <br />{'� . . . �' y I�� <br />Atatl aCnrrss <br />Mad Aadress <br />ly.�ll i/.��L-. `> l <br />EleCtrical Conlrnctor Mail Address <br />•r <br />�i� �/li/>•� ( <br />Slate License Number <br />Proposed Use of Buddm9 <br />Descdption of Work to Be Done: /;,• �, r/<� _t <br />I <br />IJOTE: WIRING IN �IuN-DWELLINGS IS REOUIRED TO <br />I BE IN RACE4'lAYS, MC OR AC CABLE. <br />� b� <br />G ty <br />City <br />` 1c .c. <br />C'ry <br />«-+- -� '%(.. <br />SWte'Zip <br />Stata/Zip <br />(.. '%�'>!%G <br />Stale/Zip <br />Contract Price of Work <br />� 'f (u r <br />Phone <br />Phone <br />i � r /l ' /C' <br />Phane <br />Contact Persun (Plan Rewew) <br />CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br />�� � hereGvi cert�h� �hat ! lrave �ead and ezanvned fh�s aupOcafion and Mnow the same te be true and <br />' ��: meoi All prr,ws�ons �11aws anC ordinanr.es yove�mnQ this type oi work wdl Ue compiefed <br />�vhefher spec:hed herein er not 7he granling ol a permrt dces not resume (o grve au�hcnry ro <br />. �ulate or cance� the prev�sions o� any ofher s�a�e cr �ocal 'aw rnguPting consfruction or the <br />. aeAormance ul construct�on. Thel I am autha¢ed by the owner �! this property fo per'� �m fhe <br />, ,vcrk lor wluch appircafion is maUe and 1 comply wrth fhe Stafe Cantracfers Law 78.2' iiCW and <br />: 96, 200 WAC. ., <br />FEE <br />G�I � -� - <br />� , i <br />