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��.1.. 20.'; 1':�;Fv C! :�=-'��; x�:.:�v <br />,� <br />V,. )��� . [ <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERE7T, WA 98201 <br />A25-257-0810 - FAX 425-257-8857 — vmw.everellwa.org <br />APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br />29 z� C�,ea,��� �� <br />PROJEC7 ADDRESS <br />Ownef <br />�°v�� F�. <br />Tenant <br />�'l L/���,�, <br />Eled�ical Con�ractor <br />blail Atltlress <br />Mail AtlAiesS <br />AdCfC56 <br />Ciry <br />�y z3 � <br />Cily <br />� . �ts 27i <br />cay <br />�.��/� 5�rh '� — <br />State License �umber <br />/�,�.�u� . <br />Proposed Use of uilding <br />StoterZip <br />'v�sr <br />SIBIC/ZIp <br />�sta� <br />Phone <br />Phono <br />��"i�y./.�/ <br />2L�• <br />% /ys� �' <br />Gonlract Price of Work <br />����-tc <br />COMad PersOn (Plan Review) <br />Descriplian of Work to Oe bone: � l�Li � h ��-✓ �w� S �'/3� � 5�-� <br />` ��// <br />/!✓ � _ <br />NO7E: WIRING IN NUN-DWGLLINGS IS REQUIRED TO <br />E3E IN RACEWAYS, MC ORl1C CAdLE. <br />CITY O� EVERETT LOCAL SAL�S TAX CODG IS 5105 <br />1 heroUy cort�ly thal � havo road om <br />correct. A!1 proviS%nns o/latt's antl <br />�rhotherspoc�6odhu�einornat A <br />vlolstr. o� concellhe provrsions ol � <br />pedom�anceo/consfrucfion. TNeI <br />�rork for �rhlah appL•cation is maCe <br />zsc.zoa w,�c. . <br />eaamined lhis application anU knowlhe same fo be true and <br />rdinanc:os govem�ng fhis ty�pe o/ �srork �rill b0 cornpletod <br />± gronting ol a ponmt doos nof nresume to g��o awhority ro <br />ry otfrer statu or local la�v requ/afing cons Vuction or fhe <br />nm outlro;izeU Uy tho o�sner of this propoRy fo podorm tAe <br />�rtl I cornpry �ri1n (he Sfate Contracrors Lan 4827 RCW and <br />��,r �_�i e� <br />FEE <br />