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ELECTRICA.L PERIVIIT APPLlCATION <br /> ClTY OF EVERETT PERMIT SERViCES I <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org I <br /> APPLICATIONS ARE ACCEPTED Ff20M 8�,M TO 4 PM � �.�b`� <br /> l �1 I? 13� sT: y 7`= �az C�rz�.��02 fxP�'�o�r' <br /> PROJECT ADDRESS <br /> tin-?�I- K�s� <br /> �C,viD.c,ccc� /7�CT�c�� lM.e9• C,clt� . 13z( Co�oY c�uc, E��tr;WR� 98Zo6 <br /> Owner hlail Fdtlress Ciiy S�a1r.ILp Phone <br /> S ►4�,� <br /> Tenan� �Aail Address Cily StalelZip Phone <br /> Yzs-;g�_oz G <br /> Jb l'�1�S0(� ECf�(�Cj 1 r.«• /($ � ,cf� �tG'' s r• /<<2t�t�a cJR �0 3Y <br /> Eleclrical CoNrac�or Mail Atltlross Cily Slale/Zip Phur,c <br /> .=lol-l�.(s� t 3��IR� /i,C��/iU ZY000 �°� <br /> State License Number Contract Price of Work <br /> nr�r ;�o� ��� ��{��,� ytf s�►-szz <br /> Proposed Use o(Building Contact Person (Pian Review) <br /> Description of Wark lo Be Done: ( 1`����Q �0(J(iGC- Y'fM�� G lV�0�"�'� 't" " """'I <br /> W i/�,c�G- ��2— C'D/�clt�R- ��rt+uS�o�. <br /> -- --�x7�r,�-cD �x�S�`��- fll� �Gt� ,¢S �-�u�2eD: <br /> NOTE: Vv!�21NG IN NON-DWELLINGS IS REQUIRED TO FEE <br /> B� IN RACE'NAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hernby ce�tily(liat I have reaci:md examined fhis application and kno�v fhe same fo be Irue and <br /> coricct. All prov�sions o/Imvs ard o�dinances governmg fhis type ol�t�ork�vill be completed � <br /> v:he(her specilied herein ornot The�rantmg ol a pennd does nof presumc fo give a�dhorrty lo <br /> violafe or cance!16e p�ovisior.s ol any olhe�sfate or local!aw regul�fmy construction or fhe O <br /> �edonnance o(consVuctior. That 1 am aufhorized by the o�vnero(this property to perlum�Ihe � , <br /> wak lor�vh�ch application is made and 1 comply�rifh the Sfate Cantrnctois Law 1827 kCtV and �� <br /> 29G.2C0 WAC. � <br /> � � Q� � *�° � � �' <br /> igi a er � Date <br /> �.;� _. <br /> I <br />' _— _ _" <br />