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PROJECTADDRESS <br />Ovmer <br />�LECTRICAL PERMIT APPLICATION <br />CITY OF EVERETI' PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98207 <br />425-257-8810 - FAX 425-257-8857 — www.everetlwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />Mail Address <br />Ctry <br />�0�6����3 <br />Gc �io•-�'a5 <br />State2ip Phone <br />� <br />Tenant MaliAanress City State2ip . ahone <br />EIEC�fICal COOlfBCto� Mall Address <br />Giry <br />�.��IUS�Ce.�OD(nD �-- � '��"- � U <br />Stn!e Lim.nsC Numbat � <br />proposed Use of BuBding <br />Description of Wark to Be Done: <br />Stale2ip Pnone <br />� �. ¢[� <br />� <br />Co"nt�2U Pnce of Work <br />/�-I./ // <br />Con�act Person (Plan Review) <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE W�.ACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT �OCAL SALES TAX CODE IS a105 <br />! hvroby certily that 1 hyve read and examined this applicatron and Fnow tho,camo te oe tnro antl <br />co�Ct. Aq proviSrCnS oIlatvs ond aNinanceS aov9rping fhiS typB Of WorA wd! De complefod <br />�rhB(1)2fspecihed herein or noL 7he ,qra�tint� pf a peiilut dces OOt rtsume ro give authanry to <br />violale or canccl fhe pmvisions of any ofhar stata oNOCaI law rBpuPating ronsenictron o� rhe <br />perlurmance ol cnnstruttion. Thaf 1 am autltonzed by the o�vnero/fhis propeny to perlo�m the <br />��rork /or which applicalion is maAe end I comply wifh fhe Stnte Con�acfors Law 1827 RCW and <br />296.200 lh'AC. <br />. 1� los <br />�; <br />sg� c�� e oeco <br />FEE <br />i0/t0 3�Fid �I2l1�313 3StiH� T076Z9809E TL�Ot 800Li90/0T. <br />