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0 <br />I <br />i <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT 1'ERMIT SERVICES <br />3200 CEDAR �TREET, EVERETT, WA 98201 <br />425-257-SB10 - FqX 425-257-8857 — vv�vw.evereriwa.org <br />� G-6-b6 <br />APPLICATIONS AI�E ACCEPTED FROM 8 AM TO 4 PM <br />�� �ONU�,�v V��rV(�' <br />PROJECT ADDRESS <br />� Z� h S1" �A 2TN � (1-S <br />Ownef Mall AAdrass <br />Tonanl Mail Address <br />U(- l A-o� C't,� �i M c. � 1Q4,21 <br />Electrical Contractor Mall Address <br />U�T2rn i�� �l�i� <br />Stato Licenso Number <br />Description of Work to Bo Done: <br />NOTE: WIRING IN NON-DWELLINGS IS <br />BE IN RACEWAYS, MC OR AC C <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 here6y ceriify fhaf f have read and examined fhis applrc <br />correct. All provis/ons o/laws and ordinances novernln� <br />whefherspecified herein ornat. The �7rantinr� o(n permif <br />viofate or cancef tho provlslons of any othersfato orloca� <br />p3dom�ance olconstrucffon. That I am authonzad by thc <br />wo; k lor hlch appficnfion is made and 1 complq wlth fhe <br />296.200 AC. <br />� �?�z-_- <br />��_��..._ <br />aiY <br />Clry <br />� ��� <br />city <br />C'o 6 ob-o <br />Slale2ip <br />SWtefLip <br />t,.� D ���-�.] 3�� <br />State.2ip <br />Contract Price of Work <br />Conlact Person (Plan Roview) <br />.- <br />(W I�l� TD �c�s <br />TO FEE <br />and know t7ie <br />vn� of work w� <br />s <br />lo be frue and <br />ompleted <br />a authority to <br />�n or the <br />perlorm the <br />27 RC W and <br />�� � <br />�vOL� - U`�— <br />Phone <br />Phone <br />Phone <br />j•d 90Ii LS9 09E p�o,}pe�q stne�� e0i�L0 90 90 ��C <br />