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ELEGTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERF_Ti, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPI_ICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � _ a � �� <br /> �l( L � /Z7I�/Pl�'JL'._ �.� � <br /> PROJECT ADDRESS <br /> � <br /> � <br /> � ��� �/f �� ' S ? ' ' <br /> �' � � r����;_, f�' ��•l;-i l,';1 i � <br /> Owner Mail Addr� Ciry State2ip Phone <br /> �'f�- «t e_ f1-S� /�`� o i� e_ - y�� 2sz -o s�l <br /> � <br /> Tenanl Mail.,ddress Cip� Slale/Zip Phone <br /> �� /� /� � Ju2��v.�i� �Js � y� <br /> D�L�/'NC c���r- i_: T �i�G���,z��.�r�/`Hde- �+/�" ��a y2! �i �'� <br /> Eleclrical Conlraclor Atail Address City Slale2ip Phone <br /> � <br /> u/�L !' G� �:s4 l57 ���' <br /> Slale License Number ontracl Price of Work <br /> j%\ C' 5����`,�/.q�. / �LGG4 FNi //Pj� <br /> Proposed Use of Bi'Iding Conlacl Person (Plan Review) <br /> Description of Work to Oe Done: ��� U/C- C— ��7�.c'�/� fJ'�!/� /�i,Q�v_ <br /> . <br /> � ,�J � �' <br /> Sc°�� GC'�, /'Y G� Q/7/e'. %�C'!'�i�G/s/�l-- G' ��'�Gf� <br /> INOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABL[. <br /> I CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> 1 hereby certily fhat I hnve read and examined Ihis application end kno�v the same fo be true and <br /> correct. FIII provisions o/laws and ordinances govemin�fhis type of work will be completed <br /> whefher specil�ed herein or not The granlinr�o(a pemut does nof resume to give authonfy to <br /> violafeorcancelthe Provisionso/anyotherstateorlocalla�ti�reguPtingconsWcfionorfhe <br /> pedomiance o�constructiai. Thnt 1 nm oufhonzed by fhe ownorof fhis property to peifomi fhe <br /> �vork lw uhich application is m��de and 1 compty�vith the State Confracfors Law 18.27 RClNand <br /> 29G.200 N�C. � <br /> � <br /> i , <br /> ,j', -� � � ��, .�?-- <br /> /. ;:� -� �� _ <br /> . �:L__---- � <br /> � � . <br /> � Sic�naWro Dale . � ^ <br /> O�� <br /> . � <br />