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ELECTRI�Q►L PERlVIIT APPLICATION <br />LITY OF EV�RETT PERMIT SERVICES <br />3200 CEDAR STRFET, EVERETT, WA 9820'I <br />425-257-881G - FAX 4� 5-257-BE�57 – www.everettwa..�rg <br />PPPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� =' "� � � � i <br />' ii <br />-i <5 ��� /_� e' lv (> � I f' � �- r, � �' � ' ' �'i <br />PROJEI:T ADDRESS <br />�- IC ���'��PNLC/ �,y `i )�j�l� :�L �•L� /�II�I (L-/i�('� <br />L�r����� — � ��- - -- <br />Ownr,r � Atail Addrr,ss c:ity Stale/Zlp <br />Tc�nanl <br />C��L� u f %�� -�� � <br />Eleclrical Contrar,tor <br />���N��t� �y�; S�-/�- <br />Slale License Number <br />. <br />�u,;�. (��, �� �, �,,, � � <br />Proposed Usa n Puilding <br />hlail Address <br />°i 7) 5 <br />A1rnl Addic ;s <br />Gty <br />i��:;��i P/,/l�h� G� <br />- --� - <br />Cdy <br />/� �P" c r' L�F�Gy��� <br />DeSuq�Uun ol 6Vuik b.� l3n I)unu_ /' l L L� �(X Gf S(�• <br />, <br />/ ��,,� ��� ��; *�,, �( -� a�iy <br />—1—�� <br />NOTE: WIRING IN NON-DWELLINGS IS REQU�RED TO <br />[3E IN RACEWAYS, MC OR AC CAk3LE <br />Stale/Zip <br />�03 / <br />Slale/Zip <br />� j;�y ti�v �- <br />Coniracl Prico o( Work <br />Conlar.l Porson (Plan Review) <br />� � <br />�' �f//// <> <br />� <br />L��/-��� <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereGy cerir/y fhaf 1 have �end nnJ e.r��nuneA fhis app6c�Vion �nU hno�v the same fo be hue �and <br />cenuc(. All p�ovisions ol la�sti and o�durances yoccrnmg fhis �.}�pe o! werk �rill be compleled <br />�rhefhe� spocilfed herein or noL Tho grantuig o! a ponnR do�:s not �rosurne to [�ive authonfy fo <br />violale or cancel fhe provisions o/ any o(her state o� local le.v ro�ulnfin� consVucfion or fhe <br />perlonrianr.e o/ construction. Th.if 1 am nuthorired bp fhe vwner ol this preperty fo perlornt Ihe <br />wo�h 'rn �rhich applica6on is made and 1 cornply �rilh the State Confrac(ors Lew 78.27 RCW and <br />7.4b.200 WAC. . / <br />�-' �. � / <br />.,��.� - � �� � �t� O� <br />i <br />— tiigiia we �ate <br />rUVLI�� -L��� <br />�: <br />� c, <br />Phane <br />Phonc <br />Phone <br />