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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVEkETT F'ERMIT SERVICES 3_ 31—/O <br /> 3200 CEDAR STREET. L=VERETT, 1h'A 98201 C1a03�-���( <br /> 425-257-8810 - FAX 425-257-8857 -v✓ww.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 3/G � rtl����p ���e . <br /> PROJECT ADDRESS I <br /> l�'r%'�/v1f✓r'�+/G�'�5�' 7'/�i'%A��l�� f.��� �if�(�' l,/� �✓�v� yJj'�i ���OC� <br /> Owner ldail Address � City State/Zip Phonc <br /> TenaM Mail Address CiP�� Slalr,2ip Phone <br /> �'//�i.K,! �'�s�iG. �s°.�,�3,61'f'ull'��'N�; '�'�G�'"/:'R/1/3 �e < .�� L' � ,J"��/.tr <br /> Eleclrical Contraclor Mail Address City � Slata2ip Phone <br /> �%%>..,.'��'�rG/.� _ ���SJ <br /> Slale License Number Contracl Price o(VJork <br /> l��/< � Y�('/'��-! — <br /> Propused Use ol Bwlding Conlacl Person (Plan Review) <br /> i <br /> Descriplion of W urk w 6e Done: _�'/�J� r" l tz�.�, Gt//'/`i�A` - 1�i1��t! !�� �i�e , <br /> A_ �1 —�--' <br /> �fl ✓� /s'/�T s<�J�'lla� /r_� Gc/.j�.�' �:�'I'�d,.�'�.� <br /> NOTE: WIRING IN NON-DWcLLINGS IS REQUIRED TO FEE <br /> i BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily ihat I havn road nnd examined Ihis applicafion and kno�v Ihe same to be true and �- � �3 _�5 9 <br /> ronecL All pravfsions ol fan�s and orciinances�ovemmg fhis type o/�vork will be complefed � <br /> n�hefher specilied herein or not The�ranfing o(a pernut docs not presmne to give aulhority to <br /> ciolafe or cancel fhe pruvisions o!any other state or local larr regulafing consfn�cfan orfhe <br /> perform;.nce olconstruchon. That 1 arn authorized by Ihe o�vner ol this property fo pe�form Ihc <br /> �rork lor�ahich application is made and 1 comply�sifh tNe State Ccntracfois Law 18.27 RCW and <br /> Z96.200 WAC. <br /> = 3, 3/ � /� <br /> Signature ate <br />