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PROJECT ADDRESS <br />=� <br />, <br />, �� a � <br />O vner <br />ELECTRICAL PERMIT APPLICATI�N <br />CITY OF EVEF',ETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 C; 0�02-0�l7 <br />425-257-8810 - FAX 425-257-8857 — www.everetlwa.org �— J b-06 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />"'� I==. L�1 �D � � � <br />S r�'--c�� -�', Co <br />Tenant <br />Electrical Contractor <br />Mail Address <br />�c�V�R_ <br />Mail Adtlress <br />Mail Address <br />/7 U� <br />City <br />City <br />City <br />�v � � r � T �8 zo3 <br />Slale/Zip <br />Phone <br />y z.5 33a —I 5 6g <br />SlatelZip <br />Slate2ip <br />Phone <br />Phone <br />STf�TC /='c./;'1:T -/- �ti/✓ �yNI�w�D 9903] �}-z5 77 f 3�. <br />Stale License Numbar � UI O �\ Contract Price of Work <br />� <br />STAT c_Fc: /6� C� G /�.��� <br />Proposed Use of Building Contact Porson (Plan Roview) <br />Doscriplion ol Work to Be Done: T C-M 1� J��- v � C�= <br />��_ ,-T�, _t L l� �Z �__. J <br />NOTF: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC rABLE. <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby ceriily fhat I have read and exarnined fhis applicufion ord know fhe same fo 6e Irue and <br />conect. All p�ovisions ollaws anAorAinancas g�vomm� fhls type of woik will be complefed <br />whefhe� specilied here;n or noL The �rantinc� ol a pemuf does not resum� fo give authonty fo <br />violafe o� cancel fhe provisions o/ any ofhei stafe �r local law repuPting consWcfion or fhc <br />performance o/ consfruction Thaf 1 am eufhorized by fhe owner o/ fbis property (o peAomi tho <br />work loi �vhich applicatbu is made and 1 compty wifh fhe Sfete Confractors Law 1827 RCW and <br />296.200 11'AC. <br />\ <br />+ �'11t��� _—��Q� � — � � — zc-�� <br />