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ELECTRlCAL P�RMIT APPLICATION <br />CITY OF EVERETT PERMIT SERViCES � 0 90 4-oq 5 <br />3200 CEDAR STREEI, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-;'57-8857 — www.everettwa.org y_�..� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� � � "' � • � �� C �� � <br />PROJECT ADDRESS <br />1�--. \� �'1C'���� t <br />Owner <br />i <br />Tenanl <br />A�'.r'� ��t-LT� <br />Mail Address <br />hlail Address <br />\`1Z�1 lS �� <br />Eloctrical Contraclor Mail Address <br />R v-� �� <<i �,`� N ; ' - <br />S�alo Licunse Number <br />_�1_ �•�_ <br />Pwposed Uso o� BuilA;ng <br />City <br />r.�ry <br />�25 -Z3`� -L`-�� <br />S1ate/Zip <br />Slale/Zip <br />Phone <br />Phone <br />c� ��10Z� �J�1D , Cj�j7 �Q . <br />Cily Stale2ip,3f�Z�SI..,C�O3� ��one <br />�� <br />�� � � <br />Contract Pnco 01 WorY, <br />Contact Person (Plan Reviow) <br />�Z� � �C,G.�_ � � i z�v lh"' � %�,,�/��C� <br />Doscriplion o( Work Io Bo Done: I`` �- `-' <br />� <br />\/`ti� � (` �C<<�, <br />NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO <br />BE W F:ACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerid}� fhat 1 have reaA anA eR�mined Ihls np.iic <br />correcL All p�ovisions o! laws and ordinances yovPming <br />whether specdied herein ar not The granting of n pertnd <br />violafe or cancel the `uovisions ol any olher sfate or locai <br />pedormance oI :onsfrucfion. Thaf 1 nrn nufhuriz c <br />work Ior which �plic.pti0_ir is mado cWd! comp with ie <br />29&?OO��C. --... ( <br />� 1�� '1�; <br />and know the samo to Go frue anA <br />'ypa o/ worN wdl ho complefed <br />s nof preswne to give aufhonty fo <br />regulatiny construclion oi fhe <br />io� o! fhis property to perlorm fhe <br />� ConUactors Law 78 27 RC W and <br />� �� 1 I ��< <� <br />FEE <br />�a4o y- �95 <br />