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EL.ECTRICAL PERMIT APPLICATIUN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425•257-8810 - FAX 425-257-8857 — www.everetiwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ,'_��i� ','� � _L.f,�'.Y_ <br /> PROJECT ADDRESS <br /> I ��r�r�� r� �-;r��Y, <br /> OWnot �dail Addmss Clly SlalelZlp Phone <br /> Tenant Mail Address Cily Stale2lp Phonr. <br /> ` �I l lfl�ill T �U�.�1�}��. � i1�3 Z(o�Si' ��1� lJl�) J�'1N�Xu�) WA `�(n2`7 ✓ �{2� j0�b ��`�I <br /> [ler,�rir.�l Con�rac�or M11ail Addross City Slale/Zip Phone <br /> ' :, i r�,f�I�. I Da� K-2 Ll'S6� <br /> Stato Lir,onse Numbcr Confracl Price ot Work <br /> � ,�� I� <br /> Proposed Use ol Duilding Con�act Parson (Plan f2evinw) <br /> Descriptiono�Work 10 Do Dono: (,Ji i C� 41 Ew :� �`-L. ;,6� �'�M1� SC�.U��C -- — <br /> NOTE WIf21NG IN NON-DW[LLINGS IS REOUIRED TO FEE <br /> C�[ IN RACEWAYS. MC OR AC CABLE. <br /> CI7Y OF EVERETT LOCAL SALES TAX COD[ IS 7105 <br /> 1 heieby r,cr6/p lh;if I have�cad nnd�rarninrd flus app6cnfion nnd know Ihe sante fo be frtm enA <br /> cnrrecl. All p�owsions ol laws and o�dmances goreminq fhis type o!�sork will Ge comp/efed <br /> whofher speci0�d haein ur not. Tho�ran6nc7 0/a pennR does nol presume fo�ive authorify fo <br /> riolete or cencel Ih�Ivovisions o!nny ofher stafe or locnllaw regu/afmg conshucfion or fhe <br /> perlonnance o!consiruclion. Thef I am�uthorized by fhe o�sner o!this property tu poriorm fhe <br /> wn�k tnr which epp6cefion!s made and 1 r�vnplp �nfh fhe Stefr.Conhaclnrs Law 18 27 RCVN anA <br /> 79f Z00 WAC. <br /> � ,-'—�----� <br /> ------ - -- —. ._.. . . . _ _ ----- <br /> :iiqn;�turn Date <br /> i <br /> � /! <br /> ��, � <br />