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�L.�CTRICAL PERMIT AP�LICATION <br />�..^.ETY O� �VERcTT PERMIT SERVICES <br />3200 CEUAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-88:,7 — www.everettwa.org <br />APPLICATIUNS ARE ACCEPTED FROM 8 AM TO 4 P.^.^. <br />� <br />330 �. A- � . _� ���_��, <br />PROJECT ADDRESS <br />, , , <br />.�.� , <br />Owner <br />Tenanl <br />Jc\ � _ �`1 1'1 <br />Mail Address <br />M11ail Address <br />� , c��-;1 '\Jv.� �.; �l. <br />Clty <br />City <br />,�, '�-J f �� ol � � � : <br />Stale2ip <br />SWte/Zip <br />Phone <br />Phone <br />��.�,-" 1-�,� lti�_1 }� ��1�-"t� C 1 l t�'.l �JJIc .i7`� .:i r���4\�s���� `\ ��� 0=�c1 � U� S ii j'- <br />Eleclrical CoNractor MaJ Address Ciry State/Zip Phone <br />���_� J � �''-� � - �� � � =-� �� V ,\ <br />SI210 Licens�� Number <br />FYope�ed Usc ol [3uildinu <br />Uescriplion of Work lo �e Done: Yl�l_�\C'.�� ��-C'.�i � <br />Conlract Pricc o( Work <br />Contact Person (Plan Revicr�) <br />NOT[: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br />l3E IN RACEWAYS, MC OR AC CABLE. ��� --y7 <br />CITY OF EV[RETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certily fh.it I ha�e read and exa;nined (his applicafion and kno�v fhe sarne to 6e frue and �1' u 1�-�C� ���` ` <br />coirecf. All provisions ollaws and ordinarces �overning this t}�pr. o! work ttill be complCled <br />u�hether speciLed herein o� noL The gronting o(a permit does not resume to give authonty fo <br />vio/afe or cancel lhe provisions ol any other stafe orlocal la�v reguPting consiruchon nr fhe <br />per(onnance c/ consfrucfion. That I am authonzed by the o�vner o( flus property to perforn� the <br />�roih lor �vhich applica(ion is rnade and 1 compl}� with (he State Confractors Lau- 18.27 RCW and <br />296.200 N'AC. , <br />�c. <br />�� <br />�, <br />