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ELECTRICAL PERMIT APPL�CATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETi', WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.evereltwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� "��- � ��V �;�r� � �i /J�7I� �-L lz>,� �; ���f j <br />PROJECT ADDRESS <br />�z _�'�i <br />�--0 9r Z--i <br />4�5"as�-4� <br />.t�i��_'?.13 — u <br />v;EGrL 5ca �i � s-J �l PdnITNt! «'1-'� s,Jo�o.z� �s �-y w,� i'S��v <br />OWner 67ailAddmss qry Stale2lp u�S_�S3�o�i7 <br />J�G.�;�i(—l��I�i�o-j �zd�' �VG�GIMµ�LuI.�Y{f'�c% �UclCEil�Wi{<"S�iN <br />Tenanl Mail Address Ciry State2ip Phone <br />/JLd.cl S�i:S/L✓L't 'yL`D f /.3 %� Y�- St <br />[leclrical Conlraclor Atail Address <br />�t/t o,J s� � G� w� i� <br />Slale License Number <br />Proposed Use af Building <br />y�s'-��-�vy <br />119, LL C/�'z�c; .� N��o%� <br />Cily Slale/Zip Phone <br />�, r <br />—�'0 �'G ;� c� • <br />Contract Price o( Work <br />Contacl Person (Plan Revie�v) <br />Descriplion of Work lo Do Done: ��� �iL"2% �- L L c i l�-/� � �L �. �- / e� C r1 L <br />NOTE: WIRING IN NON-DWELLINGS IS REDUIRED TO <br />BE IN RACcWAYS, MC OR AC CABL[. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />! hereby certily that 1 have read nnd examined this application and kno�v fhe same (o be frue dnd <br />conecL All provisions ollaws and ordinances goveming this fype o( �rork will be complefed <br />whefher speci(ed herein ornoL The grantrng o( a pernut does nof presume to give authonty to <br />violafe or cancel fhe provisions of a�p� other state or local la�v m�ulatinc� consWcfron or fhe <br />perlonnance o/ construction. That 1 am aufho�ized b}� fhe on�ner oI fhis property fo peAonn fhe <br />�vork lor �vhich applicafion is made and 1 comply �vith the State Con6actors Lew 18.27 RCIN and <br />29G.200 WAC. <br />�. ... _.---� <br />� � <br />-����i- i�- � - o T <br />S F ;iluie I Date <br />FEE <br />