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ELECTR[Ci�L PERMIT APPLICATION <br />CITY O� EVER�TT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — v,�nnv.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PMA <br />%���'; l�_ii� rl�� l,� <br />PROJECT ADDRESS <br />C� , �,'�_ <br />E o7oY /63 <br />L�L/'iz�( riz�u�� �v� �{VrN�. (l.}J� 4zS-33y � <br />Owner Mail Hddress Ciry State/Zip Phone <br />Tenanl <br />( '� �7L� ✓i[ C7Z � <br />Eleclrica� Conlraclor <br />A1ail Address <br />��d �`S/6 <br />Mail Address <br />}f�,� �vl � Z 7�j 13 n�l <br />Slale Licr,nse IJumber <br />�>; ,� � �� -�,c,� i(.. y 1—�� ��Z �, N4 <br />Proposed Use of Buildin� <br />Description of Work to �e Done: <br />/ �;%C'. �i N <br />NOTE: WIRING IN NOtJ-DWELLINGS IS REQUIRED TO <br />DE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Cily <br />City <br />C r� <br />iD <br />Slale/Zip <br />Slate2ip <br />Phcne <br />>o `iz53771', <br />�� .S���O. �� <br />Conlract Price of Work <br />%�,E.�� y,�y,n c � <br />Contzcl Person (Plan Review) <br />CC!!'r C <br />1 hereby certily fhat I have read and Pxamined this applicafion and know the same to be frue and <br />correcL All provislons o/laws and orrlinances goveming this type oI �rork will be completed <br />whefherspec�fied herein ornoL The �ranfinc� o/a permd does nof ��resume to give authonty to <br />violafe or cancel the provisions of any other sfate or local latv regulafing consfrucfion or the <br />perfomiance of construction. That 1 am authonzed by (he owner of this property to peAomi (he <br />wo�k lor which applicafion is made and 1 contply u�ith fhe S(ate Cont�acfors Law' 18.27 RCN� and <br />29G.200 WAC. <br />: � i9 <br />�. Z 3' C� 7 <br />FEE <br />�' �:�%(�i�( � �L%} <br />Phone <br />k <br />