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I <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />32U0 CEUAR STREET, EVERETT, WA 98201 �� C1 ��b <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org �� p b.-�` a�� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />5vq 95�� C�. 5.� . C�t��1i <br />PROJECT ADDRESS C c 1 N I I <br />�%'1 e(� / l' � U✓�1_Q S � F� o I <br />Owno� Mail Addross <br />o- �9zv I <br />G,o✓< Si. �n�1 B %/1a7yf��l�v (,�J�. 3Eo._�,y.�s7q <br />Cily S;ate/Zip Phone <br />�✓1Co�e %�afifS lb�l Gro•'cSI unl�-� /IIc+/rsvillt Ll/c,. ibZ7c- 36u'659•15; <br />Tenant Mall Addross CI� StalolZip Phono <br />Eleclrir.al Conlreclor Mall Address <br />� /l-'C a 2 /-� � q I �l /V s . <br />Slato Liconsa Numbcr <br />Proposed Uso ol 6uildinp <br />Descriplinn ol Work to Oe Done: �_1 <br />_ - -- -- � C? l; n�� � <br />r <br />NOl [ W IRING IN NON-DW [LLINGS IS REQUIRED TO <br />C1G W RACEWAI'S, MC OR AC CADLE. <br />ciiy <br />Sta�e/Zlp <br />Contracl Price of W ork <br />Con�acl Person (Plan Reviow) <br />CITY OF [VERETT LOCAL SALES TAX CODE IS 3105 <br />1 h��ri�hy rrrt:Iy Ihaf I hnrv rood nnd �xnmined fhis applicntion end know fhu samo fo bo huo nnd <br />corrocf. �N pr�ivisions ol la�vs nnd urdinnnces pove�rning thls type ol n�ork �s;i! bo complefed <br />�59io(firxi sprcilioA ha�e�in or noL The �ranfin9 0l n pmmd does r�of uesim:o fo givo oulho�iry fo <br />wnlah� ui aincrl Hie !novisions ol nny other sfafo ��r Iccol law,-e�u��ling consVuc6on or!he <br />perlonn;mco ol constiuc(ion Thtif I.vm nirthorimd bp Ihe o�t�ner ol ttris pwNmri}� fo peAoirri fho <br />�vorA lor n�hich npplicalia�t 15 rnnd�� nnd 1 comply wifh fhn Stnfo Conhnrt�rs Lnw 10.27 RCW nnd <br />79fi.200 11'AC. <br />�/� � <br />tf , ?/tl.l �— r�- �_ �C� — <br />uJf � <br />fEE <br />Phone <br />f- � <br />�, i. �. ! ` � � <br />