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�� i <br /> � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMI � SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.evereUiAfpRrg <br /> APPLICATIONS ARE ACCEPTF.D FROM 8 AM TO 4 PM <br /> ��� � � Z� <br /> T'�-�-� U`�'a•v�/J'v<' <br /> PROJECT ADDRESS <br /> C�ry o� .Ev er< 77' g�o z C—, ,s:�u k:/rro /.�/�.� <br /> P4�ks a...� Rfc Ev-e�rT�" W�}- 9�03 yzr-zsZ�3 -Z <br /> OWner Mail Address Cily State/Zip Phune <br /> / '7'C /7V 6��C <br /> Tenant� MailAddress City Slale/Zip Plione <br /> ��rcTri c 1N-PST f'l/7/v6r�, ST. /LJr��-enoc.� 1�t�i¢ 9P'�77 �6oy/9-9.�7 <br /> EleclnCal Contraclor Mail Address City Slate2ip Phone <br /> ELG- cTwlo 30�/ �y� S'oo <br /> State License Number CnrUact Price of Work <br /> /�'/ /7� �j'�V✓J G <br /> Propnsed Use of 6uilding Contact Person (Plan Review) <br /> Descriplion of Work to 8e Done: VVa / (.va�/ /j 9�T�n � <br /> NOTE. JVIRING IN NON-DbVELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY DF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby r.e�iJy(hat I have read and examined fhis applicafion and know(he same lo be tn�e and <br /> correcL All p�ovisions ol laws and ordinances govemmg this type ol wo�k will be comple(ed � �j 0 Q��'O�� <br /> whe(hn,r specdied herein or noL Thc prenfing ol a pennd does not resume fo give authonty to � <br /> violale or cancel fhe pravisions olany othersta(e or/ocallaw�eguPfing constniction or the <br /> performance o/cons6ucfion. Thaf 1 am aufhonzed by fhe o�anr,r oI fhis Uroperty fo perfo�m fhe <br /> work lor whir,h applica(ion is made and 1 comply_y+i0�tlie Stale Conlractors La�v 18.27 RCW and <br /> 295.20Q WAC. =� / / <br /> � <br /> � � S /`,' ��/ ��2� 7 <br /> Si�nalwc '" oate <br />