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ELECTR�CAL PERMIT APPLICATION <br />CITY OF EVFRE i � NERMIT SERVICES <br />3200 CE�:AR STREET, EVERt::T'. WA 98201 <br />425-25i-a810 - FAX425-257-8857—www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br />�I `� G-�,�.�,.�1' �}�� . l „�,� � <br />gPROJrECT A^D,DR1EI�SS <br />/(�0..tt`�/� ,'�Ir�rll\� <br />� <br />[l-'� `��Z °( <br />i'f � r�,� �� - �/ �'l-,��... .c" ,�� r� �-, tf <br />� <br />Owner Ma�l Adtlress City S�ate2ip <br />Tenanl Mail ACdress <br />C!(�ephu.«� E/r�/-�«4� ��/U3�' ���-`-i/��.s�_ <br />Electriwl Contractar fdail AAdress � � � <br />Lxc�PE�`�C,S�Z9 <br />Slate License Number <br />� / <br />S�/ly''t' r4:t.l�/- /�._3�! C��f �L <br />1 / <br />Proposed Use o1 Bwlding <br />Cily <br />City <br />�o. i �^n z <br />���/i,"��Ly (L.4C� �'�.4�5�1 <br />Descnption of Work lo Be Done�. � _ <br />r — / J-- <br />�`[ ill(•t�iGE �✓�/��L ,C]ci!'44-� + _' <br />p� � <br />NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO <br />BE IN RACEWAYS. MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 7705 <br />�Zs•-Jyy—s <br />Phone <br />StatelZip Pnonc <br />ui� QPz � z �lzr--.r� - <br />State2ip Pnone <br />cc• <br />z�,ono �«� <br />Contract Price of Work <br />Contad Person (Plan Rr.view) <br />ot- 3 `�UU f�i � <br />1 horoby certdy fhaf 1 have �aud and exammed this app6ca(ion and know tho samu fo 6o t�uo and <br />corroct. All prov�sions ol laws and ordmnnros govemmg fhr> type ol wark wdl bo comploled <br />�vhether specd�od horem or nof. Tho g�anfmg ol a permd doos nof prosume to g�ve authonty fo <br />v�olafo or cancel Iho provisions ol any o(her s�alo r� local law regulafmg consfru:fron or fho <br />perlormanco o/ conslrucbon. Thal I am aufhonzeri Gy Ilro ovmer o/ fhis propert}- to pedcrm Ihe <br />work lor w appGcat+on is mado and 1 compty �vRh Iho Sfato Confn, ctors Law 18 27 PC W and <br />296200 A <br />� r ` °� L- <br />G�—� ��� ���� �, <br />FEE <br />II <br />t <br />