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( ' <br /> EL�CTRICAL PERI�IIT APPLICA,TION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDP R STREFT, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CRFDIT CARDS ARE NOT ACCEPTED <br /> �� 2 27 CPoI (�r 5�-►-�ee.�! Evereit <br /> PROJECTADDRESS <br /> C 1 �L Oa- �I/LYe'�'� <br /> Ownef Mell Address City StateZp Phone <br /> C0� - �u� Pnn�r..y�� 3227 C�lar �t ���•�ff wR Q�zso <br /> Tenant Mall Addrese Clty StateZp Phone <br /> �i2P P/i��-ec��onlnr � 730 �,�/�S� Qo/ t=v.erpfl v�A �rd'Z�% �/ls"2Sio96 <br /> Elecldcal Conlractor Mail Adcress Clry Sta�e2lp Phonu <br /> Fi�� PI � �21 ML 3� •°� <br /> Slate Llcense Number Conlrect P Ice of Work <br /> �j S I�ou�ArS <br /> Proposed Use of Buii ng Conlact Person (Plan Review) <br /> Jescriptlon of Work to Be Done: (�0 W VO�'�CiC P �1/P A�C.f n'1 <br /> NOTE: W IRING IN NON-DWELLINGS IS REOUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLi?. <br /> CITY OF EVERETT LOCAL ShLES TAX CODE IS 7106 <br /> 1 bareby certily fhaf I have read and examined this applicaNrr,and know the same to be true end <br /> correcL All provisiuns ollaws end ordinances governmg this type ol work will be completed <br /> whefher speci�ed hereir,or noL The yraniing ol a permd does nat�• resume to give authonry to <br /> wolete or cancel the provisions ol eny other slafe or local law reyWating construction or the <br /> peAormance ol canstruchon. 7hat I am authonzed 6y the owner ol this property to peAorm the <br /> work lor which application is made sntl 1 comply wdh the Sfete Contracrors Law 18.27 RCW and <br /> 296.200 'vV C. <br /> (�- {L'�uJll�� �6 U7 Q j <br /> ipnawre Dale <br /> �O ; (� � 'o� 3 <br /> 1 <br />