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SEP-18-20�7 18:25 From: To:2578857 Pase�2'3 <br />( <br />� <br />� ELECTRICAL PERIVIIT APPLICATI�N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 Cj � I g—O 7 <br />425-257-8810 - FAX 425-257-8657 — www.everettwa.org � O 7 D-�'j `.l l( <br />APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br />l�0 � �cxr'ci �n �oaa� � Ib I <br />PROJECT ApDRESS <br />Mail AJdress <br />Slate/Zip <br />' `�. <br />7 <br />3? z :' <br />Phnne <br />�L�Y �-.`. . - � . <br />Tenanl Mall Address Cily SIi1e2iD hcne <br />.�. . n .. ., . .. `.'{'Z J`'^�' <br />FIBClnC21 COMf3ttOr � Mail Addwyy <br />�S U N �r���Fq�js� D �7 <br />State Llcense Number <br />Pro�wsed Uso of �uiidin� <br />Dcscnption o� Work ta On Donc� � �� <br />., . . . <br />NOTE WIRING IN NON-DWEI.LINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CA�LE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br />C11y <br />�20 2S$'31oS5 <br />:;toir,iliV Phono <br />.� �g�d <br />Conlr�ct Pricc of Work <br />K1Z/l S%.c�C� � _ <br />Con12c1 Pcrson (Plan Itoview) <br />S•� � <br />I�EE — <br />1 hereby certl(y (hnf 1 have re3d mid �xnmined fhls applicaflon and know fhe 5ame to br, frue and l � <br />COrrect. Aff provrsions ollA�vs and ordinances poveming th'rs fype nf wafr wifl be comp/efed E o1 U� ' l <br />whe(her spedfied hernin ornot 7he pranting o/a pemuf does no� prasiune to give authnnty ro <br />vroiara or canco� ��;o ^rovrsions ol any other stale or lucxl law regul3tfnp construcfion or the <br />perlormance uI cnrrs�rucfion. That 1 arn authonzed by the owner o/ fhis propeRy fo py�?omi fhc <br />�vcrk fw �vhicR npallcation Is rnadu and 1 comply �rffh fhe Sfa(e Con(recfas law 18.27 RCW and <br />19G.200 WAC. <br />�(�-� �1 �l 7 -D <br />