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EL�GTRICAL ��RMIT APRLICATiON <br /> CITY OF EVERETT PERMI'T SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-L57-8857 —www.everelt�va.org <br /> APPLICATIONS ARE ACCEPTED FF20M 8 AM TO 4 PM <br /> --1li,c,l�-s�,-� r_vc.��crn- �i'd'o7-J3 <br /> PROJECT ADDRESS --�— <br /> �� ���.�e' �- — <br /> Owner Atail Address Cily State/Zip Phone <br /> 5,4m � <br /> Ten3N ldail Address City State/Zip phone <br /> �SS �I e �r;L ac� !/- Z�'� S7`. SC' E-"t�-�U� WYi- 5'X�3 <br /> E�eetrical Contractor 6foil Address Cily StateiZip Phone <br /> l� s.7-c=� � ,� r�a a � a- '�' iuo� . �� <br /> Slale License IJwn6er Conlract Price of Work <br /> ���„�,,.�,,-h � c, ���� �'� h,�s�,.�. <br /> Proposed Use of Buildinc� Conlxl Persun (Plan Revie,v) <br /> Desr.riplion o(4Vork lo�e�one: � `J ry!U �LQ O� �{7 f�tir �y�C <br /> � �. d <br />. <br /> , <br /> NOTE WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RHCEWAYS, MC OR AC I:ABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily fhat I have read and exarnined(his applicatior. and hno�:�he sarne to be fruo nnd <br /> conecf. All provisions o/la�rs ard ordinances goveming this lype ol�xerk �rill be completed <br /> u�hether spea6cAherein or noL The gianfin�o(a pennd does nof iresume fo give aufhonty fo <br /> violate or r,ancel Ihe r�ro��isions ol an}�o0�er sfate er local lnw regulnfing consfnicfion or fhe <br /> pe�lonnaucr.•o/ca�sln�c(ion. Thal l ant aufhorized by the o�rner o/fhis property(o pe�funn fhe <br /> �vork lor ivhich aNplicalion is rnade and I cornply�vifh(he Sfale Con62c(ors La�v 18.27 RCl1�and I <br /> 296.20G WAC. <br /> i <br /> , � �L•-�_ i <br /> Si�naNre � Date � <br /> fib�> - � � 3 <br />