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ELECTRfCAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> !1�'�s A�rpor-� � <br /> PROJECT ADDRESS <br /> ,� ��Ya� A ��r� � ��zr��f �l�' 90,0� ����-y�a-3�a� <br /> �8� Mail Adtlress <br /> Qty State/Lp Phone <br /> 7 11 11S'?� A r'Po�-� � C�e✓e�ty 7•t/R. `15'20i ��U yS'`t-3P3h„Q?ne <br /> Tenant <br /> Mail Address State/Zip <br /> `��un�Irc+ r�c,S n(� 10`�i3�i SnJ Ar��v Tuu�ry�i�� D�. �i7UkI� S03 0l P„Oe7Z <br /> ElecVical ConirectOr � Mail Address State/Zip <br /> \/Ul� N�7 E�J��^ �C1 r' � ��7 UUQ <br /> State License Number .� / <br /> Con[rad Price of Work <br /> lhQ�f �i✓�C,'� S <br /> COlr�m P � � Contact Person (Plao Review) <br /> Proposed Use of Building <br /> ��Z�54 e � 1 t -5/F <br /> Descnption of Work to Be Done: Qth�� �P F X � {�� `�'r� — <br /> 1r-F Cnu � 11 um �f � ( Si v� — <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS,MC OR AC CABIE. <br /> CITV OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> i hereby certiry that I have read and examined this application and knc=w the same to 6e tnie anC <br /> correct. All provisions o/laws and ordinances goveming fhis type o/work will be completed <br /> whethei spec�ed herein or noL The granting o/a permd dces not presume to give authorrty to <br /> violate or cancel the provisions o/any other state or local law regulatirrg conshuction or the <br /> peAormance of consfruction. That 1 am autbcrized by the owner o/this proparty fo peAorm tnu ��/� /�J� <br /> work lor which application is made and 1 comply wRh the Sfate Conhactors Law 18.27 RCW�o�M G <br /> 296200 WAC. <br /> �� � <br /> l� � ,✓I-� ����'�° � <br /> "gnature Deta <br />