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ELECTRIGAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, lNA 98201 <br /> 425•257-8810 - FAX 425-257-8857 —v,nvw.evereltvda.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> I 13 Co� t� � Pn� ��� <br /> PROJECT ADDRESS <br /> p�v �Za� 31 � � 6L�� 5-�-�s�,�,�<t�u�w,a ��ra� 7 <br /> Ov;ner tdail Address Gry Sta'e2ip Phore <br /> Tenant h!ailAddress Gty Stafe/Z�p , Phocc <br /> y as <br /> ��1Cl.I I,t'� E��e c, �'n� �i� �� ZU��'j Shn s�. u J�.... cl$J�/ :�7� <br /> Electrical Contractor htzii Adtlress Cdy Slate2ip Pncne <br /> ���arn t��'�c1� 1 RA- � q ��� - <br /> State License Number Contract Pnce of Work <br /> R�.m�.,��P . ���U�� <br /> Proposed Use oi Buittling Contacl Person (Plan Review) <br /> Description ol Work to De �one: L�_f� \��{�C.I.U� C�'`� <br /> _r�--�-- � �� <br /> NOTE: WIRING IN NON-OWELLINGS IS RF�UIRFD TO FEE <br /> �E IN RACEWAYS, A4C C`R AC CAOLE. �O O� <br /> CITY Of EVERETT LOCAL SALES TAX CODE IS 9105 <br /> 1 hereby ce�ti/y(l�af l liave read and examined fhis applicafion and kno�v 1he same to be 6ue and � I�-{-O ( ` ( ( 3 <br /> coiroct. All provisians olla�vs and ordinances governing this fype oJ�rcrk�vill6e complefed <br /> rehe(her speafied herein or nof The granting ol a permd does no(presume to give aufhunfy to <br /> viclateorcancellhe provisionsolanyothers(ateerlocallawre�ulnfingconstrucliunorfhe <br /> perfom�ance o/construcfion. That 1 am aufhorized hy fhe owner o/this propeRy fo peAorm fhe � <br /> - wmN(or•whiclr•applicaliun is ntadc and Fcompty a�rOrlhe�Sta(c•GonliactorrL-a�M8:17•RCW and---^-• • --= --6--^- -- <br /> 296.200 WAC. <br /> ��cl�+u� l�zz _v/ _ <br /> Signaluro Dalo <br /> �— - -- � ----- — —---- �- ---- — - - - -- <br />