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ELECTRICAL PERMIT APPLICATI��N <br /> CITY OF EVERETT PERMIT SERVICES 3 _,s—�3 <br /> 3200 CEDAR STREET, EV[RETT, WA 98201 �-I <br /> 425-257-8810 - FAX 425-257-8857–www.everettwa.org (,=130 3-1� l <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ,Bi�9 �f0��/ <br /> �d/ A y��-�.i <br /> �Oo3 uJ�sr �Hs.iro .�/ �i.�,�c� <br /> PROJECT ADDRESS <br /> ,��//{��' LG <br /> Owner <br /> MailAddress Cily Slate/Zip Phonn <br /> Tenant <br /> Ma�l Address City Stale/Zip Phone <br /> ,��tir �c�ie� -��ox 7�I m�zys�,//� �J�- 9�z�o 36a -659 oso/ <br /> Electrical Contractor <br /> Mail Address City State/Zip Phone <br /> �° <br /> �lm�i�o ����C_— - ��°° <br /> Slate License Number Contract Price oi Work <br /> �,a�oH �o��y <br /> Proposed UsE of Buildin� Contact Person (Plan Reviee�) <br /> Syvare Foo�age (If residenlial nev+conslruction,remodel or addilion) <br /> ' Descriplion o(Work to He Done: ����L �C� `3sA y�✓O4TUfs ai/fJ ��y9� ��4� <br /> � �ia //� r <br /> i <br /> I P.'OTE: WIRING IN NON-UWELLINGS IS RL=iUUiRED TO FEE <br /> � BE IN RACEWAYS, MC OR AC CAOL[. C <br /> , �",� � .�c; <br /> I CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br /> � I hereby certily Ih�t I h.rve�caJ and exarnined this upplica(ion and hno�v fhe sanro(o bv We and _ <br /> wnocL All provrs�ons o/laws anJ o�dinances yaveming this(ypo o/wark�vill bo comploted /'.. I 7�(. �— / L� 7 <br /> �,•.liclher specA�cd horcin o�noL 1 ho y�an(!ny ul a pemut does not presumo lo givo aulhonty to l, � 1 <br /> iviotrdc OI C711CBI�II(3/JIOVISIOIIS OI illly OfI1C�SIiIIB Of IOCdI IU4V lClJllla(in�cons6uction or the <br /> pciloinrmco o/consfrucfion. Thaf 1 am au�hOIIZC(I fJy II70 OR'll�f O/fI1/Sp ropody to pedorm Iho <br /> �vork/ui- � ' n�s nwdo��nd I comply�vifh Uie Statu Contrac(ars Latv iH.27 RCW nnd <br /> . 296.Z00 WAC. <br /> � ,� /S-/3 <br /> � � <br /> -- �ig eNm — --- ��----- Dalo <br />