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ELECTRf�:�4L PERMIT APPLICATION <br />CITY OF FVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8tl57 - www.everettwa.org <br />APPI.IGATIONS ARE ACCEPTED FROM � AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />I'''ll0 ��2i" ,5�"res�" 5.4.1• �"13 �v�(��! T PL19T �2�rc�.S+i�� <br />PROJECT ADDRESS <br />p���5 N�M<s P,o. � � �► �����f �J,�� - <br />Gwn �r Mall AAdress Cdy Stale2ip <br />yzS <br />�7.�-163 � <br />r'hono <br />Tenanl A',.�i nddress City Slatc2ip Phono <br />� y�s <br />���0� �l<�'�r�� y`1o5 !�3''� �i�� SE• ���ir� ���'' 9P1-�5 33Y- <br />F�eclrical Coniraclor Mail AAdress City Slale2ip Phone <br />f�v,� 5��,� II op r� <br />Stalo Licens� Number <br />T�Er�l�v�-Y �v,✓�� �p� E _ <br />Proposed Use o( 6uilding <br />Descriplion of Work to [ic Dnnn: <br />C <br />�C�fl s' rty(C �'q/�tl,�L' .� O i�tn� <br />d �— <br />NOTE: WIRING IN NON-DWELLINC" IS REQUIRED TO <br />�E RJ RACFWAYS. MC OR A� CABLE. <br />CITY OF EVERETT IOCAL SALES TAX CODE IS 3105 <br />Conlrar,t�i� � Work <br />��b J"�c _ <br />Contact Person (Plan Review) <br />G <br />1 hereby cr,riily ihnf I h�rvc reaAanAexamineA fhis appli,.ntion and know L'�e snmo to bo true nnA <br />co�recL All prowsinns nllaws and ordmances �7overning tfris fype ol work will be completed <br />whelher specrlied herem or noL The granting ol a pernut does not preswne to give airtbority to <br />violafe or cancel the p�ovisions oI nny of!ier stafe or Ir.c�l I�w rogulafing consfn�cfion or Ihe <br />perforrn�nco oI conslruc(iun. Thaf 1 am �utlrorizen by fhe owner of fhis proNerry lo paAorm fhe <br />work !or which epplicnfion is made nnd I compl}� K�rth If�e Sf�te Contractors Lew I8.27 RCW nnd <br />?96 200 WAC. <br />FEE <br />_�/,�"`D ���., ����,�fi„� -- fa�,y�s� .3� ?..�0 5 <br />srz, �urc a�c <br />�osae-�31 <br />l <br />�� <br />