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� <br />ELECTRICAL PFRMIT APPLICATION <br />CITY OF EVEFiET7 PEi2MIT �+ERViCES � <br />3200 CEDAR STREET, EVcRETT, WF. 98201 3"g 7 <br />425-257-8810 - FAX 425-257-8+357 — www.everettwa.ory L Q 7 D��jL/S <br />APPLICATIONS ARE ACCEPTEU FROM P•'� TO 4 PM <br />�� 7=��, I�a LL����l � ` ,� r�z <br />PROJECT ADDRESS <br />'ydl. .L�mAn� fi I l�✓L2,� <br />Mail Address <br />O S 1'rf t/� I�; D r�� �n/ <br />Moil 1lddress <br />� ��l v\l �Y� <br />Ele�rical Contractor N..-.� Atldress <br />State License Number <br />Proposed Use of 8uilding <br />�/�`��c-rr t�, <br />��ry Stale2ip <br />'��Dr2L�� ��� <br />City SlatelZip <br />City <br />Slale2ip <br />Contracl Price of Work <br />Contacl Person (Plan Review) <br />Descnption of Work lo Be Done: �1 � � � � ✓' r �'�'�" � / � <br />.� �, ., � „rl � i/q, „i� �' C /J /f'/-L <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE I�J RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CO�E IS 3105 <br />I hereby certily that I have read and examined fhis application and know the same fo be true and <br />correcL All provisions o/ laws and ordmances govemmg fhis type op( work wdl 6e. compfeted <br />v�olete orPancel�he p/ rov sions o/ arry ofhei 9faleawlocal Ia�+ regulating consfrucf �on o�t! ety to <br />per/omiance oI construcfron. Thaf 1 am authonzed by fho owner o( fhis propeRy fo pedonn (he <br />wort: �or which applica6on is made and I comply with fhe Sft+(e Confractors Law 1827 RCW and <br />296.2U0 WAC. <br />FEE <br />Phone <br />Phone <br />Pho�e <br />