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ELECTRICAL PEf�'.MIT APPLICATION <br />CITY OF EVERETT F'ERMIT SERVICES <br />3200 CEDAR STREET, :=VERETT, WA 98201 lo ` �� _�7 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.ory <br />�O 7/� �FJ <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4!'1 <br />-� � _, ,� <br />� <br />�:�' � � /y�„ <br />PR6JECT ADDRESS <br />, <br />� �'. � , i� 't -��:. ,�_ � ii � `� ' �,� �.. � <br />Owne, Mail Addross <br />;_ �, .l. ; 1 l <br />City <br />Tenanl hlail Address Cily <br />� �'� . <br />\�� .-t-����� �t'� � =_i� �' `- � <br />Gecl�ical Conlrar,tor Mail Address Cily <br />; . �j �:/' ,� � j. <br />Slale License Number ' <br />Proposed Use of Buildinp <br />Descriplion ol Work to Oo Donc: �' �`v' l. <br />\.��. . _�� Cc '��._'( L��1 V`. <br />� ,`.� <br />,1� r> ( i ,t � <br />�-- <br />NOTI=: WIRING IN NON-DW[LLINGS IS REQUIRED TO <br />DE IN RACEWAI'S, MC OR AC CA�L[. <br />Stale/Zip <br />State/Zip <br />Plione <br />Phone <br />. I `I _- i \ J I l _` � \ � � . <br />`' I i <br />StalerZip Phone <br />�_ _ �.�- <br />�i �-���_� <br />Contract Price o( Work <br />Contacl Porson (Plan Review) <br />��,1, \J. <br />` , <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br />1 heieby certily tha(1 hm�e read nnd exnmined fhis applicalion and kno�r fhe samo to be We and <br />ccrncf. All provisions of la�rs and ordinancus �ovemin,q tlus lypo ol work nil/ bo curnpleted <br />whefher speciGed herein or not The granti,ig o! a pennd does not resumo to ,qive aufhonty fo <br />violafe or cancel the I�rovisions o/ an}� othor sfafe er local /au re�uPfin_q consWction or lhr, <br />perforntance o! censtrucfion. ihnt 1 arn n�:fhoiized b}� the uitner o/ fhrs property fo perfortn fhe <br />wo� lor n�hich application is ntade and 1 cornply n�ifh the Sfafe Cen(ractors lew 1827 RCL'Vond <br />296.200 bVAC. <br />. <br />. , � � �' i_,,� - -- <br />�_ � . <br />� Gi�na�Ure _ _ -- <br />((;rvlVV�1 C� c��.� <br />FEE <br />'� `� � , ^.') <br />, ', <br />Z; L'1 �C C,n� <br />