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ELECTRICAL PEkMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �I _ -3 �j 7 <br /> 425-257-8810 - FAX 425-257-6857 —www.everettwa.org <br /> L- n7o�� --d�� <br /> APPLICATIONS ARE ACC2PTED FROM B AM TO 4 PM <br /> _ i � � ��� �-�� �P � vr Ev�: 2c? <br /> PROJECT ADDRESS <br /> ��r��/l��P 3or5a�� ���Z `� /�3 �-d S%��cti, LYN/YW���� wy�- ��>-22�-• _ Syo <br /> Owner Mail Addross Gly Slale/Zip Phone <br /> TCnanl I.taii AdAress Cily tilale!Zip f'thone <br /> �LV t�r�,./ <br /> [ledn�:ai Coniractor A4ail Add�ess Ciq• Statc2ip Phonc <br /> Slate License Number Contracl Price ol Woik <br /> ProposcA Use ol Building Gonlacl Per;on (Plan Revicv�) <br /> Descriplinn ol VJork lu �iu bon�: �O-.� _11i'_«_�t'<'/�'<<��7 i9Z�� !>(�LC� c'cc �� �<��I/'.-.ir�4 Cu�c� <br /> i£�yL'�Y ��<<i-C'c��C>c� �[i0.,.-. . <br /> NOTL: WIRING IN NON-DWGLLINGS IS REQUIRED TO FEE <br /> DE IN RACEINAYS, MC OR AC CNf3LE. <br /> CITY OF EVERCTT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ccitily fhat I havo read ar..!exarnined Ihis appficetion imd kno�v fho same to bo fn�e and C��"�(�� -( <<i <br /> carrocL All provisions o!laws anJ a�dinances c�overnmg fhis t}��e el work �rill be complefed <br /> whefher speaGed herein or not The granfin�o/a pernuf does nef nesume to gi��e au0ionty fo <br /> violafe or„ancel(Re provisions o(an}�ofher sfate or localla�v regulating construcfion or fhe <br /> peifanrance oI crnslrucfion Tha(I am authoiized 6}�the o�rner ol fhis property to perform fhe <br /> n�o�k!n� �tihich applicafion is made and 1 cornply with fhe Stafe Confractors Law 78.27 FCl1'and <br /> 29G.200 INAC. <br /> 1 / <br /> r: . .�.% � - � . �j - �'J <br /> 1` <br /> Siuua�we Da;e <br />