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ELECTRIC�V,� RERII�IT ��PPLICATION <br />CITY OF FVERETT PERMIT SERVICES <br />3200 CEDAP. STREET, EVERETf, VVA 98201 <br />425-257-8810 - FAX 425-257-8857 — wwnrv.everettwa.org <br />APPLICA710NS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�� Z � _�G � n -� �'�.l'�'�/ �L /�-� <br />PROJECT ADDRESS <br />Mail <br />Mail <br />Cily <br />Cily <br />Electrical Conlraclor Mail Address City <br />�.�n�iLS��/-l;� j���/-f 1z"� G�� <br />tate I.icense Number <br />,� O -1. C.._ <br />�roposed Use of �uilding <br />u_l 3-D7 <br />L� D > D�% �//� <br />�2�- �S�'%- I�QJ <br />Slate/Zip <br />�v � <br />Phone <br />�a -/2%% ���1Zv�V <br />Slale2ip2 !/ Phone <br />-/ ���- 7`t 7'- �� � <br />�LifQ,�%C l�/�/¢�_ % U�2CJ <br />StalelZi �. Phone <br />4Z5= 4i�9�;-310�' <br />����v vv <br />Contract Price of Work <br />Conlact Person (Plan Review) <br />Descriplion of Work lo Be Done: f�/J/J /iN '�r �l�L� �� '6 �'f% /ti J 11f <br />� <br />,�?�� �T/ /i? �t �� <br />NOTG: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerlily that 1 have read <br />correct. All provisions ollaws a <br />whether specified herein or nof. <br />violafe or cancel the provisions <br />peAormanceo(consfnid�on. L <br />work lor which applicafion is mc <br />296.200 WAC. <br />fhis applicatiou and know fhe same to be true ond <br />govemrng this lype o/ work will be cemplefed <br />�l a perrmt does nof presumo fo give authonty fo <br />do orlocal law regulatinn consfrucfion or the <br />�zed by the owner of Ihis� roperiy fo pe�orm fhe <br />v with the Sta�e Contra;;tors Law 18.27 RCW and <br />FEE <br />v��_�i� <br />� <br />