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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 I`-�—�� <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org �� ��� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�9/l �!C �i. C�- �/�- �c� � � <br />PROJECT ADDRESS <br />, -, , , 3C,v <br />j''��iz ���-ixL�v l/7L�C, �/�O:Irc l.i� !/�Cc�si,//�� �1�1 )/ C�.I � 7�� l� <br />Owner Mail Address Clly Stale/Zip Phone <br />T�nant <br />Mail Address <br />�-t�, � ��� 1�=�_�,z � r) ��t�k I 7�(��r" <br />[I�clric�l Conlractor Mail Address <br />� <br />$ r�(r�r,��S��NI— <br />S�aln Licnns� Numbor <br />; � � �' �_, 1 �T'/7• [� <br />Prnpn;nd Utic O� Bud�Lng <br />Description o� Work to lie Drine. <br />� <br />' ��C.J %1/)/1� .i / <br />NOTG WIRING IN NON-DWELLINGS IS REQUIRED TO <br />Ei[ IN RACFWAYS, A1C OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX COUE IS J105 <br />Cily <br />���� <br />���Y <br />Stale/Zip Phone <br />/' �n ) C/,a I— <br />l.%�-Op�� /�/�T �l�t'�t�2 3 3� C 3F <br />State�Zip Phone <br />_ 3 �C��� <br />Contract Prico ol Work <br />{rJ�(/l� /(�P.��I•l <br />Contacl Porson (Plan Revir.w) <br />I hor��b�� ce�61y lhaf 1 havr m;�d nnd �xnminrJ Ihis npp6rahUn and pno�v fho sume to be frue rvnd <br />rnnrr! All prov�ti�ons nl lmss and ordutances c�oveimnc� th�s type nf wo�k wdl be conrplefod <br />nhr(hrr spocdied heiern ur m�L Ther 9ranhng o! a pennd di�os nnf nrsurne fo give nulhordy fo <br />� iolnf�� o� cnncrl fha I�rovisians a! nny ofhrr sfale or loc�l Inw rrpu�n6ng conshuchon or fhc <br />purlorrnnnce ol cunsfruc6on. Thaf 1 arn nuthonred by fh� owne� ol fhrs prnprrfy to peAonn fhe <br />work fur which app6coGon is madn and I comply wdh fhe Sfnfe Conhncfors Lms I fJ 27 RCW and <br />: 9G.700 WAC. <br />ti�pn.iuu�� <br />.�— C � (r� � � <br />� �1� (r/�f/'r <br />FEE <br />�C%6���� � �� ��, <br />