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tii:sizoi2 os:o� ra� <br />Q�ooi <br />ELECTF�ICA� P�FtMIT APPLICATION <br />�17Y OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />42G-257-8810 - FAX425•257-8857-www.everettwa.org <br />I� 2-�'— iZ <br />APPLICATIONS ARE ACCEPTEQ FROM 8 AM TO 4 PM Z <br />���ZII —I � <br />I �p c�,,}-r, F�ven,u� 5 E <br />I PROJECT ADDRESS <br />Ovmer <br />Tenant <br />Electrical Contractor <br />Number <br />� esr <br />Proposed <br />05 ��+-h Y?+.�vzu e. S f <br />�� Mail Address <br />�i Mail Address <br />�'ce Elec.�-r'iG 1 <br />MailAddress <br />Cily <br />Cify <br />StalelZip <br />State/Zip <br />,VI,J 5-tRnu�CDc� <br />Clty State/Zip <br />$p0.00 <br />Contract Price ofN/ork <br />Contact Person (Plan Review) <br />Descnption of Wod�. to �e Done: /�E�-J �ov � p�ervi Ge <br />NOTE: WIRING IN <br />BE IIJ RAC: <br />I � <br />CITY OF EVERE7T LQ <br />� I hea36vi certi7v thaf I hd <br />or <br />Phone <br />P1ona <br />Phone <br />�-DWELLINGS IS REQUIRED TO FEE <br />�YS, MC OR AC CABLE . r � <br />� i��� <br />.L SALES TAX CODE IS 3105 <br />�ead and examined Ihis application and kno�v the same fo Go We and <br />�ws and ordinances govemmg th�s type of wo�k wil! be complefed <br />rnof. The g�anfing o(a pemut does nof prosumo fo give authority fo <br />�ionsolanyotherslatcorlocal;awregulahpgconsfroc6onorthe �flr ��, <br />�n. Thaf 1 am oulhorrzed by the owrs�o(th�s property to pedo�m fhe L„ <br />is made and I comply wifh fYe Sfafe Confractors Lavi 78.2? RCW and � � <br />—�- - <br />r--��-ia <br />