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ELECTRICAL QERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.ora �_� 6-6(� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM L,%���_� z Z <br /> o�t� � y adE,—.n^h�E A�c 6'yEf.CT� �i��)C % <br /> PROJECT ADDRESS <br /> Li�i', /'7a�- �inP2 ��3�%y .ti/r��vqC �9✓�+ �✓(Jtff .,dp °�UJi� Y�1-'I�l�YeStJ <br /> Owner Mail.ddress Ciry State/Zip Phone <br /> Tenanl M11ail Address City StatelZip Phone <br /> Crf�� E/. c�1�� c �Jl•/' �i�a�/Av� cJ_ E�/It��.�v�l „✓P 9,A��.z� y.�5-)7f-15�•� I <br /> Elecirical Conlraclor Mail.��ddress City State2ip Phone <br /> ��O <br /> � �Sc��� Tl�Cr3 � ��J `��1,��/l/ `�_� � yc� <br /> Stale License Number Contract Price of Work <br /> ?� s, ��r �r <br /> ;�,�kE M�,�fi,.,� ,, <br /> Proposed Use o(Buildinp Contacl Person (Plan Revie�v) <br /> Description of Work lo Be Done: T^ S fG� n�'�'� �e����'�-S • � � `'�������"��� <br /> NOTE: WIRING IN NON-DW[LLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CIl Y OF EVERETT LOCAL SALES TAX COD[ IS 3105 � <br /> 1 hereby r,e�tily th�n I l�a��e read and examined Ihis npplication and kno�r the same lo be true and E��r�a- � � <br /> conecf. All provisions o/13ws and ordin�nces governmg this type o!�rork�rill be comnleted <br /> �rhefher specihed herein or noL Thc granfing ol a permd does nof �esume to give aufhority to <br /> ciolafe or cancel Rie provisions ol any other sfafe or/ocal law reguPfing construcfion or fhe <br /> perlormance el r.onstrucfion. Thaf 1 arn authorized by Ihe owner o/this property lo peAorm fhe <br /> u�ork for which applicafioii is ntaAe and I contpty wifh the Sfafe Con6�actors La�v 78.27 RCLV and <br /> 2J6.200 WAC. <br /> r. <br /> -� - � � - � G�- D �- <br /> --��=� '� ua�e <br /> Fmnal�.,ia <br />