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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PcRMIT SERVICES <br />3200 CEDAR STREET, EVERETT, N/A 98201 <br />425-257-8810 - FAX 425-257-8857 — www.ev�retlwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />5,�► �i S�-� C��- � E L�, r`� <br />PROJECT ADDRESS <br />oW��� <br />Tenanl <br />/` t�� r� �\ , <br />Elodrir.al ContracWr <br />I�C4� �Dr�Ue l7 <br />Mall Address <br />M�il Address <br />� �n � � <br />Mall Addross <br />\ <br />�-1'� �E ; �13�1n-'i- <br />S�ale Uaanse Number <br />cuY <br />Clly <br />Clt). <br />�., �� <br />%� �' :-�- ��✓`�' � t i Cl �.. �✓e11 U;�� <br />Proposed Uso ol Oulldin{�� <br />DoscripGun ol W��rk lo Oo Uunu <br />� a� wr �' 1 �^� i� <br />NOl"[ WIRING IN NON-DWELLINGS IS RE�UIRED TO <br />0[ W RACEWI�YS, MC OR AC Cl1CiL[ <br />CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br />(o - 9-bP <br />� ��406-o4�j <br />�Z7� �bC�GS�T�� <br />Slale/Zlp <br />Slale/Zip <br />r�,onc <br />rhone <br />� _�c�l� G�Z- ul � 33'�53 <br />SlalolZ�P Phone <br />5 L��L% -_ <br />Contract Prir�. � �f SVorY <br />�) � <br />��.. �L�-�P.JrJ.'1 <br />Conl�i� i 1���e;un IPlan Roviow) <br />1 hrrrby ��rrfily Ihuf I hm �a nraA nnd ex.�nunod Uus ���iphcafian nnd know fhc stunv to bc 6ue nvA <br />c�wrrf �111 prt�risions of lews nnd ordmnnces .4u�rnrinl� fhis type o! wor� will Go comploted <br />�}hrfhw spaciliod herein o� nof Tho pran6n� ol n pennd does no( n�+surne to g!�-e aufhnrity (o <br />���olatr �v c;uicol fhe �rovisions o/ nny c�fh�a stn(e o� locnl la�r ro,yulaling consVudion or Ihe <br />perforrnanro ol cons�rucfion 7hnf I nrn eufhonzeAbp fhe o�cno� o� this property fo perfonn tho <br />�+arh Gn ���hich npplicn(iun is nmdo and I comply �t�ifh fhe Sfofe Conlrncfors Law 18 27 RCW end <br />?9G Z00 Ih'j1C. <br />-i—( 1,��'�.�� _�, "'1-Oc� — <br />'iiuna�w� —_ —_—'— OBie <br />1=EE <br />