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EL�CTRICAL PERNfIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everetb,va.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �Zv� c:���� h� , �l���vs,d `�Szo t <br /> PROJECT ADDRESS <br /> �5 i�-�t�At, }.� uT�c����C��ZZDS Go��(�J�s�"�`��.'i �;tl�-- `�b za I �2s z��—st�� <br /> Owner MailAddmss Ciry Stale/Zlp � Phone <br /> l i�J�i°C=�i«�t��t� /�10�'�-�����/�cw�u�r ���ao t <br /> Tonanl Mail Addrass Clty Slaterzip Phonv <br /> � �'�.A,1�(�.-� B n �2oC.� <br /> Ci►'-l�Pl�t� ��SP�h'��i�a�hvts�sc�tid���o �v545 .�-Mlt;S. �� U� qoloo 7�o-o��v <br /> Eieclrical Conlractor Mail Address Clly SlalelZlp Phone <br /> l,�n�'�kD%c�r�o W t� (p , DTrO � oa <br /> Stalo Licenso Number Conlract Price of Work I <br /> ��L�T�C�-t� �a�:L411a�-TI�G 2� <br /> Proposed Uso of Buildinc� Conlacl Person (Plan Review) <br /> Descriplion of Work to f3o Dono: �����—� 11� �`'� 1� W�'�L �G��� l�f�ti� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 { i L,��, _ � j� <br /> I hereby certi(y(hat 1 hav�read tmd examined Ihis applicafion nnd know fhe sante fo bo frue end � <br /> conecL All prov/sions olla�vs and orilinances govenung Ihls type oI work will6o completed <br /> �rhefher spec�fied herein or noL The gr.�nfing o(o pemut does notl�resume ro gi��o nuthonry to <br /> violafe or cancel fho provisions of any o0ier sfafe orlocnlla�v regu nting consWction or the <br /> pedomiance o(consliuction. That 1 am au(horized 6y the o�rner of Ihrs property to perfomi tho <br /> �vork Ior nhich application is made and 1 canpty�vifh the Sfa(o Con(racfors Low 18.27 RCW and <br /> 296.200 WAC. <br /> ' �. <br /> i-, � � o �r�2��� <br /> , ,e �r�- ���.�ttfu�cv�----- ; oato <br /> Sipnalure . <br />