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� <br /> ELECTR�CAL PERMI� APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �r�y <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org �� <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br /> � 7� (o '13�r�Ud.��.� <br /> PROJECT ADDRESS <br /> �i �'�,�- i <br /> ��xw� v � 3 �. C� IIt� ���.�yS i �. LC.., a717 f��� l% t-�cl�� � ��< t�f,ct� �.,if' <br /> Owne� Mall Addresa City Stale2fp F�hone <br /> _l�u -Ir , ����.-t t�l<< �_� �3 ��> � Lo i��o��.�..�,uy f� ,��t t�- . i.�-H ��.��� 1 <br /> Tenant Mail Addresa Ciry SWte/Zip � Phone <br /> �f'J .�t/ �V (�� � S i c;v� S L4 S �� vn � �!'(J!l j-�-CI J c�-C S c q'1 I'ti� �V i'✓1� , � i//1 <br /> EleClriCalCOntfaCtof MailAddreas City StatelZip y�,- _���,_�phc+r��- <br /> `� 5� <br /> �7���r✓1/ lU�� � % ��, L S ����' �� <br /> State Licens Number Contr ct Price of Work <br /> ���'t�� l� vi ���r� �_71 <br /> Proposed Use of Ouilding Conlacl Pereon (Plan Review) <br /> �— / <br /> DescriptionofWorktoOeDone: _ � Y1S1"z� �� � � � "�-w'' Sl�� �i! `� ��Y ��� ���"-� � � <br /> � <br /> ( •.:�`-�i.\n'� d'c7v� :S �..1/1C�� �lGlV1 . <br /> 1' <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC GABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> 1 hereby certily that I have read and examined this app/icalion and know the same to 6e frue and <br /> correcL All provisions o//aws ond ordinancos govemmg this type of work will be complefed <br /> whather specilied herein or nof. The granting o(a perm�t does nof prosumo fo glve authorify to <br /> violetaorcancelt/�e provisionsolanyofherstatoorlocellawre�ulafingconstrucfionorthe <br /> porformance ol construction. That!am authorized by the owner of this property to perform fho <br /> work�or which application!s mado and I comply ivith the State Contrac(ors Law 18.27 RCW and <br /> 296.200 WAC. <br /> i I �i`� / <br /> ,,)�(,•�,.� .{.1��,,ti..-�✓�� I ��L�/v(d <br /> Signature Dat <br /> i /�1 <br /> _ , - / . �� <br /> il�_. ' .- � �, . <br />