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ELECTRICAL PERMiT APPLICATION <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 /> APPLICATION5 ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT&CREDI7 CARDS ARE NOT ACCEPTED <br /> ti71 11a,rn �F �D If.}ulf�lA)� �UP.✓�l'`�' <br /> PROJECT ADORESS <br /> �'o.roi2.. Luc�s s�� 1Jz.rat.tN„z l,k,�,5wy E�e,r-�1�-� ulA 48a�3 Nas'-35�- 9�oz.. <br /> OVn�er t.lail Adtlross Cdy State7Zip Phona <br /> �Z�,,. a_.._ <br /> TBnant Mail Addtess Clry StatelLry Phone <br /> Ecw�n J�r+�c. f�i(o� Qacfou�f-a�Cr._.� �wha�.',si.���r� 98aSo ya5-3�17- 03�9 <br /> EICGtrIqI COlilf AC10f Matl AUfrC95 CNy Sta�e/Zip Ptrone <br /> c��V i t uEL�i�o� G? � �gd.`�y <br /> State License Number Contract Pnce ef Wwk <br /> ��;.��. <br /> Prnposed Use of L�uilding ContaG Porcon (Plan Review) <br /> Description of Wak to Be Done: n�`_�nm� AQ 1�-�Il�w v k�](Jd,� ��� � " �'�"`��✓ <br /> /`�rGl,1:� -�or t�o�<Cc���1rrLm.e D[Jf"([.,'F• _ <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FC-E <br /> BE IN RACE-WAYS, MC OR AC CAE3LE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3106 <br /> I hereDycerGty tAat f have read and exam�ned this application and kno�v the same!o Oe fn�e and <br /> cofled. NI proW�ioBs of laws allU ofLlinanCCs goVC011ng thls typa o7t5 ork wi7l be mmpleted <br /> µhethcrspeciliedhnr��inorriot. Thegrantinpole portnRdoesnolpR:sumetogiveauthontyto <br /> viUlafo O!COriCcl nte prOvlslwls olany other yYnte 6r fuCa!lawlv,qu afing cunstrm:ha�i or.he <br /> pertamanee of consirvclion. Th�t 1 am outfiorize0 Uy tha ownar o/this ptipeRy to perfwm tha <br /> work Ior wbid�opp�ica(ion Is rtiade and I�rompfy with fhe Sfate CenhaYnrs La�v 70.27 RCW ond <br /> 28&200 WAC. <br /> � /7 sFrrr �-7 --- --- <br /> i'S�' ate <br /> ��7G�1 - 105 <br />