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ELECTRICAL PERMIT APPLICATION <br />CiTY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STP.cET, EVERETT, WA 98201 s d"�� <br />425-257-8810 - FAX425-257-8857-www.everettwa.org �io6S�0(�'j <br />z 31� -T�.;�o <br />PROJECT ADDRESS <br />�I—Ul �OSI <br />Owner <br />i� �� <br />Tenanl <br />APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br />`1�2�v:- -Evc-r��r�— <br />Z 3i� <br />Mail Address <br />t� <br />A1ail Addross <br />�"Ay�nrz l�sz <br />vl <br />Eu�Rc-rr W A <br />City Staie2ip <br />�I �1 <br />Cily <br />Slale/Zip <br />4z5-35S <br />r hone <br />�� <br />Phona <br />�',+"5 £IEc�R�� 506 E.MAIrJ ST. (�J�UNR.o�_ I.J� 9Q,272 31��794= <br />Eteclrical Conlracbr Mail Address Clly Stale2ip Phone <br />GSHT�;S1-( 93d RK <br />Slate Licenso Number Contracl Price of Work <br />1\CS�OCe.;�� 57�YE �KAz�c2 <br />Proposed Use of Building Conlacl Person (Plan Review) <br />Doscription of Work lo �o Done: <br />�(Z�AI<C-�.S <br />CE�(il�C..� Gt� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CA�LE. <br />CITY OF EVL'RETT LUCAL SALES TAX CODE IS 3105 <br />1 hercby ce�fily fhm 1 ha��e read nnAexnrnineAfhis applicafion and know the same fo be frue and <br />corract. All provisions o/laws and or�iinances yovemmg tlus q�pe o/ �rork will be complefed <br />�rfiether speciGed herein or noL The �ranting o(a perrnd does nof v�esumo to give atdhonty to <br />��iol.ateorcanceRhe provisionsolanyothersfafeorlocallawregulafingconsfructionorfhe <br />pwformance o/constr�uc(ion. Tliat 1 am aufhoiimd Gy the owner oI this praperiy fo peAonn the <br />�rodc lor rvhich applicalion is ntade and 1 comply �rifh tho Sfafe Conlractors Law 78.27 RCW and <br />29Fi.200 WAC. <br />S- iu (C7 <br />FEE <br />,� <br />