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ELECTF,ICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />ETT WA 98201 <br />3200 CEDAR STREET, EVER <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org 'j - 30 ' ! �- <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />Nll��� �ec�.h�u-�-E �ve�lue. <br />PROJECT ADDRESS <br />C �.�-�_!5'% <br />���� L Th�� , son r�oa8 aa�+h s+ 5E �"�h�,,, �5h ��►� ��aql� <br />Owner n���i ndaress c�y sia��a�P <br />Tenant <br />Mail AOeress <br />Cily <br />StatelZip Phone <br />/�-e� �rmanee �le�tr�c .inc. -13c�� �8and P� <br />n�u� �nwocd 9g�4� <br />ElBdriCal CoNraCtof M11ail Adtlress Cily Sta�elZip Phone <br />(�ClZFDE1 R f 9 U8' <br />Slale License Number <br />�eLv 5 � �� <br />Proposed Use of Building <br />Contract Price of Work <br />Contact Person (Plan Review) <br />Description of Work lo Be Done�. �� � 1 � I%� ��-� E� L l-J � L. �! � C/ F n�� — <br />aOv �mi� 5erv� c� <br />I. NOTE�. WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br />BE IN RACEWAYS, A4C OR AC CABLE . I� D�% <br />� <br />I CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />� 1 hmoby certily fh, f l liave read and e>�amined Ihis application and hnon� Ihe same to be Inie and �"� IZO""� _ I C,� <br />� correcf. All pravisions olla�vs and ordinances �ovenvng tlus rype o� �rork n�ill be completed G T � <br />� �rhefher specdmd herem ornoL The granfing ola pemut does nol resume to give auff�aity fo <br />� violate or cancel the provisions o/ any otber state or local laiv reguPting construcfion or fhr. <br />peAormance ol consfruction. Thaf I am aufhorized by fhe on�nerof fhis property lo perform Ihe <br />I �vork /or r:hich app6calion is maAe and 1 comply �vrth the Stafe Conlractors Law 18 2 � RCW and <br />I 296.200 l4'AC. <br />vlr � %�o�!—i� <br />