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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 /> APPLICATIONS ARE ACCEPTED FROM 8 RM TO 4 PM <br /> ) ti z 6 �Z. �t �hrL2 >�-��. <br /> PROJECT ADDRESS <br /> n 9�Z� <br /> 1 !�a D�Lu��oPJ�R ,,.f p�o , 13o�C l'Z32C �V1�mfi.ii IML� �itt'- Lsz-a3S� <br /> Owner Mail Address Ciry StalMZip Phone <br /> Tenan� Mail Address City State/Zip Phone <br /> ��.�► ��.���,�� p� r�,�z,,, �tiN �-�. �&�3C yzr-��-��-y <br /> f-lec�rical CONraclo� Mail Address City Stale/Zip Phone <br /> D},�'�� h� 97�hh ��t,2�•� <br /> S�late License Number Contiact Price of Work <br /> �2)2S2pJL,.-c.�- <br /> Proposed Use of �uildinc� Contact Person (Plan Review) <br /> Description o(Work to Be Donc: � 4�-�P S�B� �!)�C t � W��� rJ�DD��'�/� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE I <br /> DE IN RACEWAYS, MC OR AC CABLE. <br /> J <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �� �� _/ / <br /> L ��I 1 hereby certily Ihat I ha�e read and examinrd fhis applicafion and know Ihe same to be true and li <br /> conecf. All pro�asions o/la�vs and ordin�nces yavernmg this typc o(work will be eamplefed <br /> �vhelher specilied herein o� noL The�r.'infint�o!a pernuf Aoes nol presurne fo give aufhonty to <br /> violafe o�cancel the provisiats o/any ofher sfafe or local la�v rec�ulating consfivr.fion or fhe <br /> perfortnance al construcfion. That 1 am aulhonzed by fhe o�vner o!this propeit y fo peAorm the <br /> work/or which applicalion is nrede and 1 comply�rith the Sfate Confractors La�+ 18.27 RCV✓and <br /> 296.20U WAC. <br /> p]_ Z s�-08 <br /> sic�n�i�uro oate <br /> � // ,, <br /> � <br />