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US-11i2010 Oi:aB FdS J^.SJSJS�Ja E�•erFreen Securlt}� � 002 <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES S��,.ib <br />3200 CEnAR STREET, EVERETT, WA 98201 c� <br />425-257-f3810 - FAX 425•257-8857 — www.everettwa.org �/Ob J��� 1% <br />APPLICATIONS ARE ACCEPTEU FROM 8 AM TO 4 PM <br />a�a� R�F� �E <br />PROJECT ADDRESS <br />Ovme� <br />Tenent <br />Electdcal Coniracror <br />�4—�1'L SL l 1��2� <br />State Licen^e Number <br />M11all nadress <br />hlali <br />I.tail <br />���,c.�f,�, (�r� � c.� <br />Proposetl Use of Building <br />Description ol Work tn 6e Dane: <br />c�y2�3 <br />�iry <br />slalo2ip <br />Statn2lp <br />r �� ���� <br />;�Co� 212'i <br />Pno� <br />� Z� � <br />�Slale2�p Pho� <br />aa�� . �� <br />Contract Price of Work <br />1�z,4- � .�— <br />Contact Person �Plan Review) <br />NOTE: WIRI�lG IN NON-DVJELLINGS IS R[QUIRED TO FEE <br />BE IN R/10EWI1Y5, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TA%CO�E IS 3706 <br />I heieby ce�tAy fhaf I havo �ad and examincd this apU��cati0n aw Anow tha samo to Do We and � I(H� ��� <br />corroct. All provisrons of fatvs and oNmances goveming tBis rypo of �wrk will6e compinled "" / <br />N�hafher sFea4e0 herein o� not. Tho g�a�tmg ol s permd doos nutp rosume fo yinr nuthonty fo <br />viulafcorC�nCeltlre piovis�onsofenyG(herStafoorloCalla�viegulatingCcnsWCt�onorfhe <br />per/orman�+ ol construction. That I om auNonxod Gy (he owner of thls proporty !o pedorm the <br />�wrk /ur �s/uch applicahon is madx ant11 cromp/y w�M Iho Sfafe Contrnclor' W�v 18.27 RCW and <br />200 <br />i � <br />5Il(12o1a <br />