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ELECTRICAL PEf�MIT APPI_ICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425•257-8810 - FAX425-257-8857—www.everettwa.org <br />APPLICATIO�JS ARE ACCEPTED FROM 8 AM TO 4 PM <br />��'�( � "�� < . , ;��� �� �� <br />PROJECT ADDRESS <br />S-9 ��� <br />%�- C>7 bJ`�' D% <br />C,/ .� / n <br />- Y�F:��� �) �L:_� l l` �`1'�i I��' ����( �Y'C_. <br />Owner Mall Address City Stale2ip Phone <br />Tenanl <br />A1ail Addross <br />Cily <br />Stale/Zip Phonc <br />( f� s. <br />��-�--�.�E-cti�< >�Z��.�:� �;,c>rc�5i s�F' C"�� ��Y� ��:�.zc�;:.����-�=;'�:3 ; <br />EleClriCal Conlrac�or Mail Address Clly Slale2lp Phone <br />__�:��-�1�_��•'�i i���:��.� _ <br />State License Number <br />.�� �-_' l�� <br />Proposed Use of Buildin� <br />Contracl Pnco of Work <br />Conlact Person (Plan Review) <br />Descriplion ot Work lo De Done: �L���� L�. � �� i- ��� ,�C��O f'f- �—� �`" <br />NOTE: WIRING IN NON-DW[LLINGS IS REQUIRED TO <br />f3E IN FtACEWAYS, MC OR AC CABLE. <br />CITY OF EVER::TT LOCAL SALES TAX CODE IS 3105 <br />I herohv coriily fhat I have rend nnd eznmined this app/ication and know the sarne to be true and <br />corrrcC All provisions o( la�vs and ordinances govenung fhis f}�pe of �rork n�il/ be comp/efed <br />�rhether specibed hemin or nof. The granling o! a perrnd does nof uesume fo give aufhonfy fo <br />violate or cancM (he provisions ol r�ny ofher sf3te or local la�r rec�ulufing construchon or fhe <br />pedomiance o/ consfiuction. That I am authorzed b}� the owner ol ths property to perfonn the <br />�rork /or �rhich applicntion is made and 1 comply �rifh the Stale Cenfractors Law 18.27 RCFV and <br />29G.200 INAC. <br />-1�,�-�% ICl <br />l � <br />FEE � <br />-� t' S . � J-- <br />