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�LECTRI��AL I'FRMIT APPLICATION <br /> CITY OF FVERETT PERMIT SERVICES <br /> 3200 C:EDAR STREET, EVERETT, WA 982G1 a`3 `� S <br /> 425-257-8310 - FAX 425-257-8857 -www.everettwa.org (,_-p SO � �-�a3 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE NOT AC.CEPTED <br /> � <br /> � �-' � � � �j�✓� ✓c-w:�t �.f�e�� / S�t � `�� 2 j <br /> PROJECT ADDRESS <br /> /bol e�y ;�+- �9 �� ;.� t/� � <br /> �7 o q '79'6 <br /> ���c_ ' r�D<<• ��-/ Itiiccuc.��-� fx�LCc-�VKe wl� G`b'cn<'� <br /> � <br /> Owner � h7ail Add ess City State/Zip Phone <br /> G_� l,l tC:� /c;�1 r� I �v�b� h��'v� �Uo./ £U6tit"7'� u t� - <br /> Tenant M/ail Address Ci!y StatelZip (/ZP�e <br /> � ✓��1i'� �(�r���.�1/ I 7 <br /> �'�'I� i���i ��' �i"I ✓' r"/�lL�C� t.G-1'�' ��0�3 �.�Z /2Ut. <br /> Electrical Contractor h4aii Address Ciry StatelZip Phane <br /> ��n ��-� �< c��� �r 13 �9�Z�D�v> 5,C �_ �� <br /> State Li nse N�mber � Contract Price of Work <br /> ����_ci t L V I N� � lMG(r/' <br /> Proposed Use of Building Contact Person (Plan Review) <br /> J � t ,,�y-_ T �� � <br /> Description af Work to Be Done: I`�' LL��'1� 'E> >�( / S r i VI(iJ � / ��I �-� L�- S��'�.I <br /> ,� T <br /> =J-� S�z:L L �,�w = �/ c�w� `� C� �'a c.«nr/ W iJ'eL�;s _ <br /> �.c1ct C ( S �<�E�--; c.c,�[ C c.r��� c�� ���i� �L c��� � i✓��-c u�z <br /> NGTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. ��-- ^ <br /> � <br /> I <br /> CITY OF EVERETT LOCAL SALES TAl: CODE IS 3105 <br /> 1 hereby ceRily thaf!have read and examined this application and kno�vlhe same to be true and <br /> conecr. All provisions ol laws and ordinances goveming lhis rype oi wo�h wil!be completed <br /> �.vnether speci(ied herein cr not. The granting of a permd does not presume to give aufhonty to <br /> violate o�cance/the provisions olany other state er local iaw regulating consWcuon or ihe <br /> pedormance of construchon. That I am authorized by the owner ot th�s propeRy to peAorm the I <br /> verk/or�vpich applicaticn is made and 1 comply�vith the State Confractors Law �8.27 RCW and <br /> 296.200 WAC. � <br /> / � <br /> � , <br /> ��%v1 ,- l/�',z-���✓\ l � <br /> SicnaWre Oat <br /> ��� _� c�/�% �/ � <br />