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os �os�znua i�:as rnx azs:�3r,�aso �:��a��i:i.i. ia.rc�raic <br />ELECTRI(,AL PERMIT APPLICATiON <br />CITY OF E:VERETT PERMiT SEF",VICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.eve•ettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TU 4 PM <br />_��IZ� 5�+� �G S,E <br />PROJ�CT ADDRESS <br />owner <br />Tenant <br />Mail <br />Mail Address <br />Clty <br />Clty <br />�joo•�; oo•� <br />3 --6 -��i <br />� �7l 3-v� <br />14z,) ZyZ 27y <br />K wr. �d (.�n . �i°03�_ <br />Stale/Zip Phona <br />Stalo/Zlp <br />Phono <br />1la�nt.�-c.� El�:� .i �. � 4�� � S` S(L 5 Z� k�' w Ls� <br />�> -(-s� � S ln�ti4 4R �R 4-z 7,�cY� <br />[loclrica Conlrector Mall Adtlross City Slate/Zip Pnono <br />V/�R.�1 -C�-.=�i?� M6 <br />State Licunsv Number <br />_'�''] ; � i�'� � �.+ � �yy�� Lc '• "�iG�Q,� <br />Proposec uso at �ilding 1 <br />'�, I 3 I .��° <br />ConV�act Price of Work <br />Contect Person (Plan Rovlew) <br />NOTE: bVIRING IN NON-DWELLINGS IS REQUIRED TO <br />E�E IN RACEWAYS, MC OR AC CABLE. <br />CITY OF I:VERETT LOCAL SALES TAX CODE IS 3105 <br />( l�oreby c=rti/y thof / have read and examined thls applicaflon and kno�v the same fo be fru� and <br />corroct. FIf provisiuns of laws end ordinances goveminc� this type o/ work will be complotod <br />whofhor s.�ecil]ed horein or noL rhe granfing ol a pormif doos nof �rosuma fo give authont.� to <br />violafo or ;ancel tho �rovlsions ol any othe� state or locol law reguls(ing consWction or the <br />performarce oI consiructlon. Thot 1 em oulhorized by fha owner ol this roparty fo paAonn tho <br />work (or nhich application Is made end 1 ccmply with the State ContracPrs taw i8.27 RCW and <br />296.200 �/AC. <br />FEE <br />�a�o 3- az.� <br />