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ELECTRICAL PERMIT A,PPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> z�2� R���- �� <br /> PROJECT ADORESS <br /> .� � r i , � � v � <br /> Jo�n► lku+� l�� �->'��> ����� �����1�-, %�, , � ) ;��z.� < <<'a �/.��.� <br /> Owner 1dallAddress Cily S�atclT_Ip Phono <br /> � eN�i <br /> Tr.nant Mail�tldress Cily Slato2�p Phone <br /> PufR CONS��t'lbV� G9roRao5EVEtri.�w 0���'�4� !��/�4-,IB//5 �1!•.�J'fi�09f1 <br /> [lectrical CoNracto� Mail Atltlress T Ctly SIa1eIZ�p Phone <br /> �rA)►�COGL q97�� �1�D0°Q <br /> State License Number Contrncl Price of Work <br /> R�nrrnti R�i n�v� P���`Ra�+rn� <br /> Proposed Use of�uildin� Coiriacl Pcison (Plun RevicvQ <br /> Descriptian ol Work lo Dc Dona (ID�idQ-nE ����/l(,� '� �Q�w•�r�-l�— <br /> ��� <br /> NOl'E: WIRING IN NON-DW[LUNGS IS REQUIR_D TO P[E <br /> R6 iN RAC[WAYS, MC OR AC CABLE. <br /> CITY OF CVERETT LOCAL SALES TAX CODE IS 3105 . <br /> �;�li <br /> I hereby r.crtify Urn(!hrive rr.nAnnd exaimmr.d th�s application:ind l;no�v thr,same to be tn�c and � ,'�'L)� ` � �- r <br /> correcf. Illl pro��^ions all.uvs and ordinmrcos govonunq this typo olwaR will be compleferl f'�� ` <br /> wheflmr sp:cJ�ed hercin or nul. The y��mting o/a perniil docs not preswnr.fo�ivo aufhoufy lo <br /> violate orcancel the��r�visions o/any ofhersfafo arlocnl l�iw re�ultitlrp conStrucGan ar Ihc <br /> perlmmance o!cnns ruc;ion. Thnl 1 mm�ulharized by(he owner o/Ihis prnpetly fo pmf�rtn!he <br /> wo�k lor�vhic��npplicafion is rnade t�nd i comply wifU fhe SIn(e Confinctors Law Id27 RCW and <br /> 29G.200 W�C. <br /> ��?�� I� ze f za�v <br /> 5¢n �m� ���� <br /> I—__—_. — — � . <br />