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, <br />,� <br />ELECTR�CAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 C^ " � y-� �O `x�J <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org C O60 6_d� " <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�� z Z ' <br />i /6� �v-v� �/u>a v <br />PROJECT ADDRESS <br />:� G- <br />Owner <br />Tenanl <br />7;� 6 1�.,� �� ,�•rj,�:�, � �;;, :.� <br />Idail A.d•Jress City <br />�dail Address Cily <br />Ir '�/r5 P� JP�'t/1, �' " <br />ConlraCtof Mall Address <br />Cily <br />i9 �fT',� / ��ZS -z � �- i %� <br />State/Zip Phone <br />State/Zip <br />Phone <br />;,f} 9�zal yzs-z5 <br />Stale/Zip Phcoe <br />! �Li9A/�SI�lz�P �on� <br />Stal License Number Contracl Prico oi Work <br />Gfl�h l7^P i-c � � � L..: � /-�� � /cr �� <br />Proposed Use of Building Conlacl Person (Plan Review] <br />Description of Work lo E3c Done �`'��-n -�' �,�' !� � l%r i 7�'.� (.�G %� C <br />iVOTE: WIRING !N NON-DWELLINGS IS P.cQUIRED TO <br />BE IN RACEWAYS, MC OR AC Ci+BLE. <br />CITY OF EVERETT LOCAL SA! ES TAX COOE IS 3105 <br />1 here6y certily thaf 1 have read and exarnined tl�is application and know fhe same to be Irue and <br />correcL All provisions ollaws and ordinances go�emmy this tylie o( work will6e completed <br />whether spea/ied herein or noL The granting ol a pemu( does not resume fo give aulhurity fo <br />vio/afe or cancel fhe provisions olany ofher sfate or locallaw re,quPfing construction or the <br />pe�fomiance o/ const�ucfion. Thal I am authonzed by 1he owne� o/ this property lo perfonn the <br />work for which applicafion is made and 1 comply wifh the State Confracfors Law 1A.27 RCW and <br />:96.200 WAC. <br />�' i � . <br />l �� ! ' �y' !' i <br />� L- <br />FEE <br />� <br />�`CtilLCli> � C �I �. <br />