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� w <br /> � <br /> ELECTRIC.'�I_ PERMIT APPLICATION � <br /> CITY OF E�/ERETT PERMIT SERVICES I <br /> 3200 CEDAR STREET, EVERETi', WA 98201 I <br /> 425-257-8810 - FAX425-257-8857—www.everettwa.org �) � ��—�/z <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM g`,C� `�� <br /> ��'�O � ;�:/��i��� �i ,r� <br /> PROJECT ADDRESS �� �7�/�� <br /> ��` � '.> �r"G"��/1/�/1 /�D����-���� �i,�? Qd���. <br /> Owner Mall Address ly Sfale2lp Phone <br /> Tenanl Mail Address Cily StatelZip Phono <br /> G// �/f7�/��f�ii��7/✓ <br /> [ol ctrical Conlractor Mail Address City State2lp Phone <br /> Slate License Number Conlracl Prico of Work <br /> �'����;= <br /> Pro e Uso ot�uild' g fontact Person (Plan Review) <br /> .C�'L����^�C/� ' <br /> Description oi Work lo Bo Done: �� � � �� <br /> �� �C��� <br /> ( <br /> NOT[: WIRING IN NON•DWELLINGS IS R�QUIR[D TO FEE <br /> BE IN RACEWAYS, MC OR AC CAf3LE. <br /> CITY OF EVERETT LOCAL uALES TAX CODE IS 3105 <br /> 1 hereUy cetlily that 1 have read nnd examined fhis application and know the samo to be frue and <br /> corrrct. All provisions o/lai�s and ordinances govemm�this type o(�rork�vill ba complefed <br /> �rhefherspeahed herein ornot. The�ranting o(a permd does nof �resume to glve authority to <br /> violateorcancelthe provi5ionsofanyotherstafeorlocal/Fawregulafingconsfructionorfhe � I I � <br /> peifom�ar�co o/constniction. That 1 am authorized 6y fhe owner o!(his property fo perform the � <br /> n urk Ior whicl�applicafion is mado and 1 comply�tiith the Sfatu Conhactors La�v 18.27 RC W and � <br /> 296.200 AC. / // � I � <br /> c� '�' � / <br /> '`� ����� /���7//i ��_� <br /> � Sin tute Dale <br />