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ELECTRICAL PERMIT APPLICATION <br />CITY OF FVERETT PERMIT SERVICES <br />3200 CEO,�R STREET, EVER[TT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everet'wa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />r� r, l % � �^��12-�� <br />PROJECT ADURE55 <br />a�y �_� 5/irh �c��-, <br />Owner <br />M11ai1 Address <br />�� <br />�� ���.c. �� w� y€��:� 7�— <br />Cily <br />Slale2ip Phone <br />�L_L i i F'-� �,ihr.s� � r• i•"7 SFs�� c.d �,cs_l�Ti— w� y�:� � <br />YLS L_4'� (�i <br />Tenanl MailAddress Cily State;2ip Phone <br />� Cji I�—t-F'�I�IC jO ijc�T L���J7 ��aH-o....�sµ l/�� I��G��� j(;G'��T�:1.5': <br />Eleclrical ConUaclor A1ail Address Cily State2ip Phone <br />�C� H F-��L�l �7 'Z M `d <br />Stale License Number <br />� ,_ <br />� c�•� � f7��J�' r <br />Proposed Use of Buildin{7 <br />Descriplion of Work to Be Done: <br />.� � <br />a-� �,� ;�� �> i" � r��V' <br />L-1' � -1 C += <br />NOTE: N/IRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />`� � D'C> C� "= <br />Conlract Price of Work <br />_'�Y�_ <br />Contacl Person (Plan Revie�v) <br />�_ �t � j i � .v i.r <br />i�vJ <br />1 riereby cerlily that 1 have �ead and examined Uris application and kno�r the same lo be hue and <br />conect. All p;uvisions o/ laws and oielinances governing Ihis type o/ �vork �vill be complefed <br />whefher specihed hereir or noL The g�anfin� cI a pernut does not presume fo give authonty to <br />violafe or cancel lhe provisions o/any other sfa(e orlocallmv re9ulatinc� constniction cr the <br />peNo�mance ol consf�uction. That 1 am aufhorizeAby fhe owne� ol tlus property to pedomi fhe <br />work lor �rhich application is ntade and 1 coniply witlt the Slate Contracfors La�v 78.27 RCl4� and <br />296.200 Ih�AC. <br />� � � � �-1-- lj — � _ � �' � <br />ti�a�,,t���� — uute — <br /><' - <br />� �'� I i ��v <br />FEE <br />` ` � <br />.— L�� l. J- L� J 7 <br />j9 <br />1� <br />