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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EV[RETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —wwv✓.everettwa.org � _�— � � <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> Crioso�c.f <br /> 43OZ. R..iGt'��1'�non-E- Dr-iVe. <br /> PROJECT ADDRE3S <br /> Jlv+^ Le�'s�-i�GUw q�Z Q��e��uxt{- D� �-rc•'{� WFl �1$20� �25-z52-Z:a � <br /> Owner Mad Address C�ry Stale/Z�p Phone <br /> Srh� �� — <br /> Tenant Mail Address City SlalelZip Phone <br /> � _,-1�j Elrz -Ir��,LLC 15-4to -qls��� 5� ��oh�rr,�sh bvA RSLR6 3/oo-bFxS-So 0 <br /> nn� c. <br /> EleClriCal COnlydclor Mail Atltlress C�h� Statell�p Phone <br /> rrZ,tii �� R1� � z z, �ga�' <br /> Stale License Number Contract Piice of Work <br /> Slr7c��¢.�6ti��llt, �((Q¢.�nCL � <br /> Proposed Use of Bwlding Conlact Person (Plan Review) I <br /> Description o�Work lo Be Done �G�� '1" I�4� G�� w�uS'Kd ����'�'� �fy�6�-+L �d 5v b <br /> �(1'�D�� CiYIGt (Y..,OCw}�. WaS�la✓ L1Y G✓ CIVC.t+�t3 <br /> l <br /> NOTE: WIRING IN NON-DWELLINGS IS REC?UIRED TO FEE <br /> 6t IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAI SALES TAX CODE IS J�05 <br /> I hereby cerfily that I have read and examined this application and Anow Ihe same to be true and �J J US �p 3`�` <br /> correct. All provisions o(laws and ortlinances goveming this type o/work will be complefed <br /> whelher specilied herem or noL The granfing ol a pennd does not presume to give autlionty to <br /> violate or cancel the provisions ol any otlier state or local law regu/ating con;truchon or the <br /> perlomiance o(construction. That I am authonzed by the owner of this propc�rty to perform fhe <br /> �vork Ior which applicahon is made and I comply wifh the State Contracfcrs Law 18 2�RCW and <br /> 296.2001NAC. <br /> I; � 1 .��-�-�� s (� (z��� <br /> i Sig at e �� Dat� <br /> �I _ . __- ---_ <br />