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i <br /> ELECTRICAL PERMIT APPL.ICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETf, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 –wwv,�.everettwa.org ��'" 9—� <br /> C o9//�-o�f� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 5'yn i ���;yl ;�� �,a <br /> PROJECT ADDRESS <br /> =-�oz2� _Or��r�2 �����ia�M� s� l-'�,���� �.��a�N 4S z.og <br /> Owner hlail Address City Slale/Zip Phone <br /> Tenant 1,7ai1 Address Cilp S�ate/Zip Phone <br /> 5�'i f <br /> Eledrical Contractor M1.1ai1 Address City SlolclZip Phone <br /> Slate Lic �se Number ConUact Price of lNork <br /> Proposed Use o(Duildin�i Con.acl Person (Plan RevieH�� <br /> Desc�iplionofWorkto6eDone' .� LI.?J->/=1,L cZ /C � lif>l, -iC�� I � CXISTI�/ �LLIO�� _ <br /> NOTE: WIRING IN NOI�-DV'JELLINGS IS RECIUIRE�� TO FEE <br />� BE IN RACEWAI'S, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE I° 3705 <br /> I hereb�certily Ihat I have read an�exarnined Ihis application end know the sarne(o be true and <br /> correcL All provisions ollaws and ordinances govenung fhis t}�pe ol work will be cornpleted <br /> �rhefher speci(icd herein or noL The rranfiny o/a perrnit does not �esume te�ive airthordy to <br /> violafe or cancel the p�ovisions of any other state or local lair requPting construcfion or the <br /> perfomiance o(construchon. Thaf 1 am authorized b}�fhe o�rner ol fhis property fo perlonn fhe <br /> �vork lor�vhich application is rnade and 1 comply wifh fhe Slate Cont�acbrs Lou� 18.27 RCV✓and <br /> 296200 11�AC. <br /> ��.� � jt�E'�.i.c�- // - -r/ —p� ' <br /> Siynalvre � �� Dale <br /> �G�qil -u�{� <br />