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ELECTRICAL PERMIT APPL�CATIrON <br />CITY OF EVERETT PERMII' SERVICES <br />3200 CEDAR STREET, EVERETI, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — wn:.:.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />%� ��' � N ��i-�''�'i� i'✓�/ <br />PROJECT ADDRESS <br />-, -� <br />; !; :"/iE/, ���. E�tf=/-_!_ �� /.j �� % <br />/'"%/� � c FN,7'r ��t�(Y7l/.�' l l'l �i 1� �`� P� <br />Ownof Ma�l Address <br />City <br />; ��" y'y,� / <br />-- s�ierzi� <br />i � -,�o oC- <br />C0617 /d.j <br />v�'S-- <br />.� )��' S�,>.� <br />Phor.e <br />�1�, / <br />Tenanl Mail Addross City Slale2lp Phone <br />4z y .� G'� - <br />� //'";�"�i1'L t��c"//_'/C /�/1C Ci^/,c�_� ��E L✓��'E�lJ`� /�1�/ 7voj <br />Eloc�rical Conlraclo� Mall Address Cily Slate2lp Phone <br />��i''�% <� y�y / /<C <br />Slate Licansa tlumber <br />''� •��,���-,��,�L <br />Proposed Use of Building <br />Description of Work to Oc Uone r_'' U/`,� )� �cY�'��� i'/_� <br />;'/%�� / i/r�f� �, y, �f��� <br />NOT[: WIRING IN NON-DW[LLINGS IS REaUIkED TO <br />[3E IN RACEWAYS, MC OR AC CABL[. <br />CITY OF EVERETT LOCAL SAlES TAX CODE IS 3105 <br />—�--��— —` � `— <br />Conlre l6 Price ol Work <br />Conlacl Porson (Plan Roviow� <br />f <7/�', <br />I homhy ceriily fhaf I have «iad end ea�amined fhis epplication end know fho same fo be Irue end <br />can�eacf. All provisions ol laws und o�Ainances �o��ernin� fhis fype of wo�A will bo complefed <br />�shefher specilicd hmein o� nof. The granfing ol a pernut does nof nesumo to give aulhonty fo <br />violafe or cr�nccl fhe provisions ol nny othcr sfnfo or IocollaH� regu�eting construcfion or fhe <br />perfonnance o/ r.onslnicfion. Thef I nm aufhorized by the oH�nei ollhis proporty fo peAonn U�e <br />work !or which npplicefion is mode nnd I comply wifh fho Sfafr. Conhecfors Lew 18.27 RCW and <br />29G 200 WAC. � <br />�\ � . �, <br />, • �, , ' j-.., � `_ �> i� - /j C��- <br />�—_.-- — <br />s�cm:m . oaio <br />FEE <br />