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d <br />ELECTR�CAL PERMIT APPLiC�►'�'ION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-E810 - FAX 425-257-8857 — w�,rw.everettwa.org <br />APPLICATIONS ARE ACCcP TED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDc ARE NOT ACCEPTED <br />�v�� � ��f S� <br />PROJECT ADDRESS <br />(�:1J_,1- %.,�� <br />Owner <br />T?nant <br />Lv �{c;:l u.J,,��n.c,n /1u�?,,rn <br />Mail Address Cily <br />Mail Address <br />City <br />t,t/P, �(�OC3 I <br />Slate/Zip <br />State/Zip <br />'��y Si,`i7 <br />Phone <br />Phone <br />/lv �u��� E I�����L �L ^c I'U 1���( jp?�� ��,.�v 5� c�� i�A ���%y�i �z�'`i �s'YY� <br />Eleclrical CoNraclor Mail Address Ciry Slate/Zip Phone <br />M� �Uuz� u� `'� � o ���5(Xi.� <br />State License Number Contract Price of Work <br />����U���,� .�i ��;���a� <br />Propcsed Use of Bui ing <br />Description of Work tn Be Done: _ -k-v ���,(? Ul � <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT IOCAL SALES TAX CODE IS 3105 <br />Contact Person (Plan Review) <br />✓vlcr L�'/ (�cw <br />1 hereby cerli/y that I have read and examined this application and kno�v the same to be fn�e anJ <br />correcL All provisions c/la�vs and oidinances goveming this type n/ K-ork will be completed <br />nliether speci6ed herei i or noL The granting o) a pe;nut does not presume to gire aufhority fo <br />violate or cancel tha p; ovisions ol any of: ier state or local law regulatin� construction or the <br />perlormance ol consVuction. That I am e.uthorized by fhe owner of this property fo perlorm fhe <br />�vork lor which applic�,tion is made and 1 �omply wifh the Sta(e Contractors Law iy.27 RCW and <br />296.200 WAC. <br />�" /;� <br />- " `'��`L'%f �'/�/ <br />FEE <br />L �C'�7 � �G <br />