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/ <br />ELECTRICAL PEr:�iAIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 �..-31—D� <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org �-/ <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � a� b7 ��-1 <br />,. <br />-i �. Z 5�: � ��l <br />PROJECT ADDRESS <br />�� <br />�. �,, <br />J6Ii�a'v,} j �p�., ', a Ud 1 �--� . �, .�IG �'f � l� �4'=. �, <br />Owner Mail Atldress Cily <br />-,��r�����e (.0 1 °i�'�'= `��� ?i�S �'�cS <br />State2ip ' Phcne <br />l�. ,,�,p <br />1'��'��i� ��:;� �i.���iin. �L�i��li ��IZ INL�i� Ilil���nrJ��I�IV��`iCJ7t V2.S'�,`IS''i: <br />Tenant Mall Address Ciry Slale/Zip Phane <br />�11c7 �-i,��:il�� �l�i ),f�'.-.��1 C1-brIG �:i�=k6i:Y f'L'�Rl-ii �,`J� ��f" ., ����.t�l. /'�����Z <br />ElCdfiCal COnIf�C�of A1ail Address City Stale2ip Phone <br />��i�.L�.C[�l ��'��N/'� <br />V <br />State Licenso Number <br />1c,�t� ;�. -i�n„�._ <br />Pro�osed Use of Building <br />'flf,� f: <br />II q •- <br />��.� L �� <br />Conlract Price o( Work <br />�tilikt El��s�ir <br />Contact Pcrson (Plan Review) <br />Descnplion of Work to Be Done: � � r�.: � c t- �'��� %F�-'� 1� ��: � � j c: �'i �J,',f F'-Y" i C��.`;� ���•� �T-IC,�-, <br />��` , -c .',�ii.�� � <br />NOTE: WIRING IN N0�' iJWEL�INGS IS REQUIRED TO <br />BE IN RACEVt'��YS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CO�E IS 3105 <br />I hereby cedi!} thaf I have mad and examined fhis application and know fhe same fo 6e We and <br />correcf. All provisions ollaws and ordinances govemmg fhis type o/ work will 6e completed <br />�rhether specified herein or noL The granting ol a permrt does not presurtte to give at,thonty to <br />��iolate or cancel thc provisions ol any other state or local law regulafing construchon or tha <br />peAormance o/ construction. That 1 am authonzed 6y fhe owner of this property to per'orm fhe <br />work Ior �vhich application is made and I compty wifh the Sfate Contracfors Law f 827 RCW and <br />296.200 N�AC. <br />„ � i � � <br />, . _�� i/t r/ � � <br />/ ( • � y <br />FEE <br />� � .' U-, - 1 `� 1 <br />