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ELECTRICAL PERMIT APPLICAI'40N <br /> CITY OF EVERETT PERMIT SER\/ICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 '? `3� `� <br /> 425-257-8810 - FAX425-257-8857—www.eveiettwa.org <br /> c: �i�c�- o9z� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ��// � �'1 ��C���� �L��� <br /> PROJECT ADDRESS <br /> � -t"%7AC'� t�Cv�'!t Lr7V172� i0�?s �w,� �l� G�,'J�L'7T u, �4� ���C`�� <br /> Owner Mail Address Gry State/Zip Phone <br /> i� <br /> �.J�r"v-'12�7.� <br /> Tenanl Mall Address Cify State/Zip Phone <br /> 7G'`� <br /> �?r�.����irC� �FGi. r�o i� z9nn •��;r tv�4 �i��13 z� 1i9�� C� <br /> ElecUical COnlractor Mail Address Cily Stale2ip Phone <br /> ' � � eD <br /> C-',; cc � � i r. l ��ijCL <br /> Slate License Number Contracl Price ot Vvork <br /> /1'��/���t- /7�JM� J���G�2�Hi/) <br /> Proposed Use of Building ' Contacl Person (Plan Review) <br /> -SiTF i ' /' _ G ,�/(ay ,� �' � � j�iZtAtiGI'f" <br /> Description o(Work lo De Done: �C-LVL /�-. ,CL� f"r" .�` �- �Lr <br /> �F-E?�C'7L5 � l �f�(��L� ��1L�`—G� 70 �+��„� d) ( ^S G�GIGE ��Ct(� <br /> NOTE: VJ;RING IN NON-DW ELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWRYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �UiSU�- - O`�Z <br /> 1 hereby certily INat I have read and exarnined this applicafion and know fhe same(o be true and <br /> correcL All p�ovisions o(laws and ordLiances goveming fh;s type o!work will be complefed <br /> whether spealied herein or noL The granting o(a perrtut does nof�resume to give authonty to <br /> violate or cance!fhe pruvisions ol any other stste or local law regu eting construcfion or fhe <br /> pe�formance ol construction. Thaf 1 arn authorized by the owner o/this property fo perlorm the <br /> work lor�idiich application is made and 1 cornpty�vith O�e Sfafe Contracfors Law 18.27 RCW and <br /> 296.200 WAC. � <br /> . i <br /> _ . . % <br /> d ' � � (/O <br /> j l V <br /> ��.,�l,Cf ' � <br /> ;icpc�ture ata <br />