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I <br />ELEC�'RICAL P�RMIT APPLICATlON <br />CITY OF EVERETT PtRMIT SERVICFS <br />3200 CFDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICA"I"IONS ARE ACCEPTED FRpM 8 AM TO 4 PM <br />�`��� Ia�`'A-vE SE � � <br />PROJECTADDRESS <br />� Ov:ner <br />� <br />Tenanf <br />��z89$ i�� <br />Mail Addre,s <br />kyer. �D� <br />Maii Address <br />Cify <br />�l <br />-�SE E� e,-� <br />City <br />J �� �--o� <br />; -c:'�/ <br />4 rl A nl.�' co 8 � s�� <br />Statc2ip Phonc <br />,,�A� 48�� �{u-ss7-s <br />Slate2ip Phonc <br />� 1�+-1�e,��cfio�.�1 S�Q� c t�,i�l t�l�,y 44 Hz �p�e�1 I,J� 9 8�5� �/zs zbs-rs�7 <br />i7ecVicalContractor 1,tailAddress City State2ip Phcne <br />I S I`I� 2. SC �^i'-1 Q�G J <br />� C�bO° <br />� State Ucense Number Coniract Price of Work <br />A <br />; Proposed Use of Evilding <br />Description of Work to Be Done <br />11�IiSS ��/}�L <br />Contact Person (Plan Revieri) <br />�,5�.�.�N4 •,II��,����,(-�� sigk4� � <br />A u % 1 L <br />l� l.C, , rt..f �✓l� '1� 2�c t ST� r�� L 1 rGrt.a �� 'r' <br />�dOTE: WIRIMG IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />! hereby cer;ily fhal I have read and eaamined this application and know (he same lo be true and <br />=onecL All provisions ot/a�vs and ordinances govemmg lhis type ol�vork u�i(I be completed <br />�,vhether specified herein or noL The grantmg of a permd does no! presume to give aulhonty fo <br />vrnlale cr cancel the provisions oi any oth=r sfate orlocal la�� regWating construcfion or (I:e <br />performance of construction. That 1 am authonzed by lhe owner ol this property to perfonn the <br />�r:ork lor which application u made a,�d ! comply �vith (he Slate Con(radors Law 782i kCW and <br />-ro� �nn inm� <br />FEE � <br />I I <br />��,�3"`�--' i <br />