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ELECTRICAL PERMIT APPLICATION <br /> CITY nF 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 Fr�OM 8 AM TO 4 PM <br /> 3817 sr� � 7�a �lY� � � z� i <br /> PROJECT ADDRESS <br /> � oYecc ��FGr 3817 .sn� �TN qICE ��'��z�77" G�/� y � zv r <br /> Owner h1ai1 Addr�ss Clty State2ip Phone <br /> Tenant A1ail Address City Stale2ip ? Phene <br /> �Z,S�I�Z�So <br /> C�-�si�E c�9t3�c �'r, �o�, o/S �1��� S7EYr.vs 9Pz�8 <br /> Eleclrical Conlraclor Mail Address Cily StafeRip Phone <br /> </a57'L C Z �2'Q�'4� L � 'l -� - I L� � 7� GDD <br /> Slale License IJumber Contrad Price of Work <br /> yzfy3� � y� y <br /> Proposed Use of 8uilding Conlact Person (Plan Review) <br /> Descriplion o(Work lo De Done: �E((Q Lp w V�LTf}�E ��JC F � ,[�/�(r� <br /> NOTE: WIRING IN NON-DINELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, M� OR AC CABLE. <br /> CITY Of EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereGy certily Ihat 1 irare read and examined this applicafion arrd know fhe sarne fo be frve and <br /> conect Al/provisions o�/aws and ordinances yoveming this fype ol�rork will be completed <br /> �+hether speci�ed herein or noL The granting ol a pennR does not��resumo to give authoriq�fo <br /> violate or cancel fhe provis�ons ol��ny other slate or loca!law rcgu.afing consWetion or the <br /> performance ol consauction. rhal l arn authorized b��fhe oirner ol fhis pwperiy to perform(he <br /> �vork lor which application is made anA l compl}��vifh fhe State Contracfors Law ]8.27 RClNand / <br /> 796200V1'AC. �� J — � <br /> — �� _ '�U. 1/L'�i�{� — — O ��T(��� �����. <br /> � ( _ <br /> Snn,.��wc Date <br />