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FLE�TRICAL PERMIT APPLIC/�TION I <br /> CITY OF EVERETT PERMIT SERVICES � <br /> 3200 CEDAR STREFT, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br /> �110�.5 i� � �vP. s e e�e2c�f <br /> PROJECT ADDRESS <br /> �2 3ob l-�,�I,.e.S �ooas iti�^ ave se � vea.ctf wA� 9s� <br /> Owner h9ail Address Cily Stale2ip Phone <br /> Tenant Mail Address Cily Slale/Zip Phono <br /> �.� S S � EP�-2�(', 1�.�� �X � y l2 [V��q�5�i1Ie W� `��f1�0 `f2S-5�8�� <br /> ElectriCal ConUaClor Mail Address Cily State2ip Phone <br /> a25 F�L- �`r� a.�a-z _ .� 7 �ac�. �J <br /> Slate License Number Conlracl Price of Work <br /> Proposed Use oi Building Contacl Person (Plan Review) <br /> Description of Work lo(3c Done: L'e MO U G F X S i S�1 tJ q_ SrU� �►M��D CG,� <br /> 0.tJ_��aC� w;�L. S(C)C) A�MP �ISoNCC�' anld 0.c� OtJC w.E��Q <br /> NOTI=: WIRING IN NO�'-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWA"S, MC OR AC CABLE. <br /> CITY OF EVERETT LOCPL SALES TAX CODE IS 3705 <br /> I hereny certi(y fhat I 1�:��e read and examined fhis applicaGun and know the same to 6o true and p� U `U�� <br /> correr,L Al/provislons o!'aws and ordinances goveming this type of work will6e complefed l� � <br /> whefher speci�ed heiein or noL The�ranting o/a pernut does nof presumo fo give aufhonty to <br /> violate or cancel the provisions o/any other slate or local law rec�ulafinc�construction or the <br /> perlomiance oI consVuction. Thaf/arn authorized by fhe vwner o/this property to pedorrn fhe <br /> �vo�k(or�rhich applicafion is ntade a•id 1 comply�vith the Slate Contracfors Law 18.27 RCW and <br /> 29G.200 INAC. <br /> _____���s 3�,� i� -c� — ev <br /> gnature ate <br />