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ELCCiRICAL PERMIT AP6�LlCATION <br />�ITY OF EVERETT PERfiI:IT SERVICES <br />3200 CEDl1R STREET, EVERETT, WA 98201 <br />425-257-8810 - ; AX 425-25i-8857 - www.everettwa.org <br />APPLICATIQNS ARE ACCEPTED FROM 8 AM TO 4 PM <br />..l %Z 7 .(�LC�6(G. � <br />PROJECT ADDRESS <br />Owner <br />Tenant <br />pr,u t/ r/L <br />Eleclrical Conlractor <br />Slale Liconse Number <br />Proposed Use of Building <br />G T;'z� lvwEr� <br />Mail .4ddress <br />Mail Address <br />Mail Address <br />Cily <br />City <br />Ciry <br />_ w� �� �,� -s <br />SlalelZip Phone <br />State/Zip Phone <br />Slate/Zip <br />Contract F rice of Worh <br />Contacl Ferso�: (Plan Review) <br />Doscriplion of Work lo Do Don�: Ld J�� /ULn ✓ � DN K,j '/POa i/Y') ,�. ,y?fFiR . <br />NOTE: W!RING IN NON-DWELLINGS IS REO�_,IRED TO <br />BE IN RACEWAYS, MC OR AC CABLG. <br />CI T�' OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certi/y that 1 havo read nnd examined this application und know fhe same to be fruo and <br />correct. All provisions ollarvs and ordinances c�oveming this type ol work �vill be complefed <br />wheUier specified herein or noL The granting ol a pemut does not �resume fo give authonty tv <br />viol;,�te or cance/ 1he provisions o/ any ofher stafe orlocal law regulating construchon or the <br />P o�rk or Whkh applica�tion / s nifl7do araid�l co'» plyedtb}�he State Co�fractorspLa W 18 27 RCiLl�land <br />296.200 lh�A C. <br />�_ /6 • 2ov <br />. � � �� <br />lJ�� �_)/��'�'`����� l��iT%lcv�l�>c(� t'.�]� <br />Phone <br />FEC <br />��� - �d <br />