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ELECTRIGAL PERMIT APPLICATION <br />C17Y OF 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 FROM 8 AM TO 4 PM <br />%G' ;lU - S� s �S i S (�r�' �s r�.�f{ G✓y %J'� ��> <br />PROJECT ADDRESS <br />Owner <br />Tenanl <br />! <br />;' � F�/�%r /C.�G �.S-/ =T <br />Mail Address <br />Mail Address <br />Sr c j <br />[leclric2l Conlrac�oi tvlail Address <br />Slate License Number <br />,�7-� ��/r...,�, <br />Proposed Use of Buildinp <br />L% ��� <br />Cily <br />City <br />Ci1y <br />,� % <br />StatelZip <br />Stale/Zip <br />Slalc/Zip <br />ConVacl Price o( Work <br />�/�S-'3/- <br />G � 57'r� <br />Contact Person (Plan Review) <br />Phone <br />Phone <br />Phone <br />/� /. [ � <br />Descriplion o� Work lo Lie Done: .�' 7 �'�L� ��� l��r �%✓�.,�Yc� ��i�Y'%/iC�k� /J J�,t7,/�., %'NP' <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />B[ IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certily tliat 1 have �ead �nd <br />correcL FlII provisions o! la�vs and o <br />whetlier speaGed herein or noL Thi <br />violafe or cancel Uie provisions ol er <br />perfomiance o/ cons(rucGon. T,hat I <br />�vork lor ivhich application is made e <br />29G.20011�AC. j <br />exantined this ap��licafion and <br />rdinances governing fhis type <br />� grantinc� o/ a permd does nof <br />iy other state or local law regu <br />anr aufho�ized by the owner oi <br />nd 1 cornply �tii�h the Slafe Cor <br />/ /'Li <br />= fo be true and <br />comple(ed <br />re authonty fo <br />fion orfhe <br />o pedorm the <br />8.27 RCW and <br />% :�?�'i/ <br />FEE <br />,�oa _ �� <br />� <br />