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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FF.X 425-257-8857 -www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM •� -p5-O$ <br /> Coyn. z -o3 <br /> � '7/ :� ��n� NH=R (� rz `7 � 'c o"3 <br /> PROJECT ADDRESS <br /> 13i\ ;'Nn� �-rt. l�`IF f ') �7ic; �.:/-� if/ �Bit I�iC � .,cK,Sii `�'�2 �•3 q2 � 'jo8r�;3�.'? <br /> Owner Mail Address Cily SLde21p Phone <br /> Tenant A9all Address Ciry 5lalelZip Phone <br /> Zac '3i9 '7411 <br /> ,_x�_c r� ccrn�c izzc-i3:`s,- r�s ,ti, l� c �c..,,;�: •�� ..� t �l �s �42 sx��� <br /> Eleclrical ConUaclor Mail Address Cily State/Zip Phone <br /> ) � L / <br /> �-�' K�`i C L 5 / 2 ".3 � �-f ,--� . Z OOo� •._`_ <br /> Stale License Number Contracl Price of Work <br /> J'�NG1�= �-dih � 1'� Jri%' � �i- <br /> Proposed Use oi Buildinc� Contacl Person (Plan Review) <br /> Descriplion o1 Work Io Be Duna �� �' �-� �`�� a t�- i_Y i..1�- iv�� ( ooA .CL��vi C E— iz. '2 C�:/i <br /> NOTE: WIRING IN NON•DWELLINGS IS RE(�UIRED TO FEE <br /> BE IN R4CEWAYS, MC OR AC CABLE. <br /> � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> 1 hereby cerii(y fhat 1 have reod and exarnined fhis application end know the sarne to be Uue and <br /> cenect. All provisions olla�rs and ortfinances govemmg tlus fype ol a�ork will bo complefed <br /> �vhefher spea6ed herein or not The�ranfin�o/a pemuf does nof/�resume fo gire aufhonfy to <br /> viola(e er cancel tha provisions ol any ofher sfafe or local la�r reguleting consfn�ctwn or fhe <br /> perfomiance olconsfrucfion. That 1 arn autlio�ized U�Ih�onner o(fhis property fo perfonn fhe <br /> n-ork Inr trhic6 application is nrede and 1 cornply u�ith fhe State Confracfors Law 18.27 RCLI��nd <br /> 296.200 6VAC. <br /> � <br /> � > c- _��. �? /�tL� �— 2 � o t=; _ <br /> 51(111��1IIC ��• ���L <br /> �? <br /> �` �,� —I � <br />