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ELECTRIC�L PERMI�' �4�PLICATION <br /> CITY 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 /> ., „ , r <br /> 1 (,' "' � -`� �;' ' �� i i� S �� vL:�^�>;; <br /> _1 <br /> PROJECT ADDRESS <br /> y. �_ _r_ :, <br /> ���� � F i F r. � � �l 5� ,�.-,r_ <br /> � <br /> Owner Mail Addrrss Cily State2ip Phone <br /> 5,1V"�y <br /> Tenanl Mail Address City Stale2ip � Phone <br /> �'C _ _ <br /> '�53 . - <br /> j , . C' . �� TF�: s��.� ��6� ?-r� c ��l� L�,vn/�,�,� t' (,�li' �' �'. ti t F�9&s- <br /> Electrical Contractor Mail Address City Slate2ip Phone <br /> /� i <br /> l� L I l: %� I U �' : �5 c_ � � �' �/ L <br /> Stale License Number Conlract Price of Work <br /> '� F D <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> �.(l; j',_ �Is w�c 0 F_L l-�� T� N�.nJ /;^.�.�° F� �.4n,� ,; rr!_� <br /> Descriplion of Work l0 6e Done: � <br /> ;-? �, �` ;'-; , ;ri Fi7,✓S ��� F^��,,��r �r.� c N��,+-��zs <br /> , <br /> NOTL=: �VIRING IN NON-DWELLINGS IS REQUIRFD TO FEE <br /> BE IN RACEWNYS, MC OR AC CAF3LE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby caiity Ihat I ha��e read and examined this application and kne�v the same fo 6e true and <br /> correcL All pruvisions o�laivs and ordinances�overning fhis type o/�ti�ork will be comp/efed . <br /> �rhether specil�ed herein or noL Thc�ranting oI a permd does nol �resume to�ive authonly to ' <br /> vio/ate or cancel the I�ro��isions ol any other sfafe or/ocal la�v rec�ul3ting constnic�ion or tho <br /> pedormance of construction. rhat 1 arn aufhorized by Ihe o�ti�ner o/this prouerty fo perferm tho <br /> �vork lor which applica(ion is made and 1 comply�vith fhe Slate Contracfors Law 18.27 RCVV and <br /> z�s.znn wac. ,� <br /> % ' «..-�,% ���✓ �, - � ,- �G, <br /> Signalure �ate <br /> il <br />