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� - <br /> � � <br /> ELECTRICAL PERMIT APF'LICATION <br /> CITY OF EVERETT PERMIT SER'✓ICES <br /> 3200 CEDAR STREET, EVERET'f�, WA 98201 <br /> 425-257-8810 - FAX 425•257-B857-www.even:ttwa.org �� `�- � g <br /> �O��/-//(� <br /> APPLICATIONS ARE ACCEPTED FROM B AM TQ 4 PM <br /> 300 , w cusr „� �'.i� # �! 5"- ��01 <br /> PROJECT ADDRESS <br /> �53 � <br /> � C. � C � (�. J�i� � c15i �J_ F-O c✓Gr�� �� � l)�� � >y6�3y� <br /> Owner � Miill Address Clry Slele�2�p Phone <br /> a� -i r <br /> v ng -s��y z� q0os W �o.sino � � � vs•so9F��re� l..�/�1 9�'al3 W/i� <br /> TC08111 �AxAAddre55 Clty SfN1C�-ip Phore <br /> - (d OL) <br /> Mo..��,-.o.\�V.• �nill.�r �� i 1 w�c,+.o,l- F�� S �i 5.��T�-U' w A 9 �(OL �h8�ya�� <br /> [lectrical Contredor f.t��i Atldress Clry Stnte2ip vnone <br /> )i <br /> ,�na�oam� �i� z e'>r- i/��/o`) _ � ��1�<<1 <br /> Stala Ucense Number Conlract Price of Work �yd5> <br /> Cc��1 n.a.,.,. c,c� i�Llqr�: ��� a �bb-5'7 0 l <br /> Proposcd Use of guUding Coitact Per,on (P�en Rev� ) <br /> Description of Wor�.to 6e Dunc. I �� e v o (-�-�ia E — i•'t s-1-� ! I -h'�c,-t- �Fr o.cz /� o v a�f <br /> Z C_I �C.u ��'S <br /> NOTE. WIRING IN NON•D�h'[LLINGS IS RE(]IIIREb TO FEE <br /> RE IN RACEINAYS, A1C OR AC C�f�l_E. <br /> CITY OF EVERETl- LOCAL SAL[S TN(CODE IS 5105 � <br /> i��� �7',ll � � -- <br /> 1 hereby eert%ly fhat I nave read and err�rrvncd th�s appG�A��o�gnd know Ihe same fo be frue a�d � <br /> mnpcf. All pmvrslone of laws and c��drnances govBmin,q;�us(ype o!work will bc cempletetl <br /> v.hethu-spec��ed herein nr not. Tne g�a�trng o�a pe,mrt docs nol presume fo pive oufhority to <br /> vinle(e or tence/fhe prvwsiens o/eny other state o�IoCallaw rrgulatm,q cons,tic(ior,nr the <br /> nnrk!or v he h app�c�afinn Is rne/de and I��ornplyµl(hyhLpStn.a Co�f 2�CI�S Levy 18?7 RCW and <br /> 79G.200 t1�AC. <br /> �----� ��. <br /> ���\ ����'s: _��.�a'``�� 11 I p <br /> _��.'_ � S�,n-lur¢ Catc _� <br />