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..,.. <br /> I <br />� ELEC��'RIC�1L PER�'I�IT APPLICATION I <br /> cirv ��� �vF���r ����ir sr�rf��:s�� <br /> ;t��-��; �) � r:l �%��1".;if�ll: i, l-�.�l -'.t.l .. u�'i� �,,,...� � <br /> 4z5-25/-8810 - FAX 425-257•8857•-www.everellwa.org <br /> APPLICATIONS ARE ACCEPTEu FROM 8 AM TO 4 PM <br /> ��r� �.��tiy �4�� ����<<«� � �.� ��1�,�„ <br /> PROJECT ADDRESS <br /> H'51z��Ut-cJE u `f►tiFi�,'Z�rC <br /> - '��� -5_ o't91J CuGi3yG`��1i� Cv[L�i<<-i� �:5-.�7! �iz5=Zs3�G�?� <br /> OWfICf Mall AddroSs <br /> City SIaI�,�Zip Phonc <br /> SV�nC., <br /> Tenanf Mall Addross c;� <br /> Y Stale2�p Phono <br /> t�4 n7,.` (y� �JLS-S3�3-�3zz �l <br /> //IFt'Zt� �f1�t�3� 7�v�ll / �19(.V`�/.�� fV1�7� �'Sf �bvnll L47A. /c1rJ'T.3 Z� <br /> ElectricalContraclor M1tailAddwss Ci1y Slale/Zip Phone <br /> S�ate Liconse Number Contracl Prico of Work <br /> Proposed Uso of Building Contact Person (Plan Revirw) <br /> Descriplion of Work to Be Done: _('�J� '�'�}q�— ��-r,��� ��� VCt-TF3t'� �' �'L r '�� �i �cy7 <br /> �l.Y eA-iJ� ��K="'Li(�J ���L f-n4A..6 <br /> I 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 <br /> I here6y certily that 1 have read and examined this app/icatio�i and knuw the same to be We and <br /> con�ecL All provisions of laws and ordinances governmg this type ol�rork�vill be cornpleted <br /> whe�her specdied herein or not. The granfing o7 a pennrt does not resume to give authonty to <br /> viofate or cancel the provisions o/any other sfate or local law reguPting construcLon or fhe <br /> perlom�ance oI consfruction. That I am aufhonzed Gy fhe o�vner o(thrs propurty to perlorm(Re <br /> work 7or wlrich ap /ication is m and I comply wi0�fhe Sfale Conlractor;;Law 1827 RCIN and <br /> 296.20�C/� � <br /> ,� <br /> � <br /> �,_� �,Gt� � z� <br /> � SignaWre � Dat <br /> / <br /> — — � �/r -/(d0, <br />