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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 C[DAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everett�va.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />y ��-�� <br />C � ���� �_ . 1 <br />i� JI� (� � <br />�-' I l �� l,� (, �'�. �--� �V � <br />PROJECT ADDRESS <br />— � 7 � —, <br />1�Uy f�>��'L'�^'� �"�C, ,�..� � � � � I� v c l< c✓� t w-(,w�.{- ��� o� <br />ONne! I ���'�I.t,nl Addiuss � Cdv Slule!Zip POone <br />Tcmnl <br />r,;i�. <br />�� <br />tila��'Zq, Phone <br />�I �s <br />f'r� W-v� L I� c�� E v�tw�.i- („%.-4 . ? 90 - 7 <br />Glr,clrical Contracior ldail Address Ciry Slale/Zip f hone <br />�'/ E S-�--e. 1 �f ,> 3 C N <br />State License Nvmber <br />��. <br />Proposed Usc u� Ruildm�7 <br />� <br />Descriplion o( Wnrk lo Be Donc: ���� �� f�-- r"D C w- <br />NOTE: WIRING IN NON-DWELLINGS IS RL-QUIRED TO <br />BE IN RACEWAI'S, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CCDE IS 3105 <br />�./JOo.oc <br />Contract Price of Work <br />��C•-✓ � �G h 5��,- L It <br />Contact Person (Plan Review) <br />v c i 97 � - %yiy <br />1 hereby certily fhaf 1 have read and en.�nrined this application and know (he sarne fo be Vue anA <br />correct. All piovisrons N laws and ordinances goveminy Ihis p�pe oI �vork �riN Ge completcA <br />�she(her sp^cilicd herein or noL 7he g�anfing o( a pernul Aoes not resume fo ��ve authonty to <br />violafe ur cancel (he �rovisions o/ any ofher sfafe or local la��•.� reguPting consln�ction or Ihe <br />performance olcons�ruc(ion. Thaf I arr� au(horized by (he o�rn�r o( fhis property to periorm the <br />�vork lor �vhich application is n�aAe and 1 comply n�ifh ihe State Confructors Lan� 18.27 RClNand <br />296.ZOOl4'AC. -'� <br />� ' �� �-�� � 8 -�8 - <br />,, , _ <br />�' Sirinatwc ���� <br />FEE <br />��C.��`V � C���l <br />