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ELECTRICAI. PERMIT APPLICATION <br />���_ ,,� �� CITY OF EVERE7T PERMIT SERVICES <br />pc�� �� 3200 CEDAR STREET, EVERETf, WA 98201 // `-S �g <br />���� � �425-257-8810 - FAX n25-257-8857 —www.everettwa.org �O g�� -0� <br />—��� � , ��a�� <br />�, ^ J� APPUCATIONS ARE ACCEPTED FROM B AM TO 4 PM <br />3 9� / <br />_ (� o� I<� ni� :i 1c-,% ��� ,� � E�%C'i � c��- <br />PROJECT ADCRESS <br />�� �,� ►�E,� I � t � z �� ��z�ti. <br />OvmCr Mail Adtlress <br />i� <br />��I 1+� i Ci �r' %�! {, <br />Tenan� -� tvlail Addiess <br />I�Ci��IP� <br />fleclrical ConlraGc <br />� l r' �(�,- r c L �-L � <br />Ma�l Address <br />�� f� ,E' r.l L'. C�`� 3�� 1� i.� <br />State License Number <br />�1' -(�C-' S��C t.,% c..i� fi-ail\.e•. C <br />Prop�sed Use of Building <br />Desaiption nI Work to Be Done: � <br />��-��: � n w� �js z�s <br />State2ip Phone <br />City Slate!Zip Phonc <br />� 1 C� C� t rG. .SF .�vc'rr'�, 6�.4 <br />City <br />� r�-,., ,. S' <br />Stale2ip <br />Z�7�GU� <br />Conlract Price of Work <br />� c./.'L � c _ <br />Cuntacl Person (Pla� Review) <br />� <br />i-^�' !'� � ��w ('7 l�'< �r �,1G ���w I S k�, , i bZ� y O �F'Y � VC-(_', <br />_—� i�_— �l-�;'>��..'� �' S I�� PccG�� ( 4 vt •f < <br />NnTE: �VIRING I�' NON-DWELLINGS IS REQUIREU TO <br />8E IN RACCWAYS, MC OR AC CABL[. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hcreby certily fhat I have read and ex�mined this applicalion and knon� the same to be frue and <br />corre�t. All provisons o�laws and ordinances governmg tlus (rpe oI �rork will be completed <br />whelher specd,ed herein or not The granling o/ a perrmt does nol �'rr.sume to give authonty fo <br />riolafe or cancel the �iovisions ol any o:her sfafe or local law regulaf.ng construc6on or Ihe <br />penurmance o/ consfruction. Thal 1 am 2ufhorized by the owner o/ fhis property to peAon i the <br />�vork /o� nhich application is nrade and 1 comply uifh the Sta�e Contracfors Law 78.27 RC�'/ and <br />296.200 WAC. � <br />, F <br />%/. �; - C' , <br />FEE <br />r c�r� -r� c. <br />