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�LEGTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVEREl-i, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.ev �rettwa.org <br />�] <br />PROJECT ADDRESS <br />�(i1r��-i �:�.., <br />On�ner <br />Tenanl <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />A1ail Address <br />Mail Address <br />Cily <br />Ciry <br />Slale�Zip <br />Slale/Zip <br />Phone <br />Phone <br />7 i� <br />/ <br />/Fl/3/�i•.�'�� I G..J'i L GG�. °.:C LN G •��ZS �Cf 5.: SL.1 ��fNNQ.�fJ(�L�l9 YSi; I% 71i-�)YL <br />EleClrical ConUaclor Mail Address City Stale/Zip Phone <br />!lra /t /� r i �,_ �i a� �/ u� (' <br />Stale License Num6er <br />'1 <br />� , "L �,A <br />Proposed Use ol L3vildin� <br />Description ol Work to Dr, Donc <br />i� <br />�:. , c :'c'l <br />NOTE: WIRING IN NON-DWEI_LINGS IS REQUIRED TO <br />DE IN RACEWAYS, MC OR AC CAaLE. <br />CITI' OF EVERETT LOCAI SALES TAX CODE IS 7105 <br />��jy�,�,� <br />Contrect Price of Work <br />� i fJ�� Ci/L�,.�. C r 2 <br />Contact Person (Plan Review) <br />I hereby certily O�af I hare read ai�d exarnined (his applicatign and kno�r Ihe same �o be f�ue nnd <br />corr�ect. All pmvisions olla�vs and ordinances govemmg this type u/ �ti�ork will be cornp/eted <br />whether spec.6ed herein or noL The granting o/ a pernuf does not resume fo give aufhonty to <br />eiolate or ;ancel fhe provisions o/any ofher sfafe or locallaw re�uPfing ca�struclion or tfte <br />N^liORilBf1CP, OICO/ISlracfion. lhat 1 am aufhonzed by the owner oI this properfy to pedomi the <br />�vork !or �rhich application is made and 1 compf}� �vith the State Confractors Law 18.27 RC W and <br />29fl 200 WAC. <br />!/-„r - G% �� <br />FEE <br />l� <br />l'(��-I <br />< ;J� <br />