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' l; � <br /> E ECTRI AL PERMIT APPLICATION <br /> CITY OF E ERETT PERMIT SERVICES <br /> 3200 CE AR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425•257-8857—www,everettwa.org �� �"(� <br /> APPUCATIO S ARE ACCEPTED FROM 8 AM TO 4 PM C-�r��6-o a� <br /> ^ � <br /> 1�3 E c.��Ja G.)fl <br /> PROJECT AO ESS <br /> OWner i Matl Address City StatelZip Phone <br /> LNU�+�1c,a (v3ol�� -��� �� r',� ac -�55-3ia�- <br /> Tenan[ � afl Aaaress Ciy SUte2ip pnone <br /> ����0 C. IEL/-/i L �LU }oZ Is� 1J2 S, �IO �C �I wFl OI� J "3G 'S <br /> ElectriWlCAnVectw MailAddress City StateTp Phone <br /> iRvE g � � ( `l ��f o G � <br /> State License Number Contrdct Price of Woflc <br /> ��� 1 _�) � � <br /> ES ra ... .9" � a'Cr/\ C3s JI.n.�w�nr� S <br /> Proposed Use of Bui ding � Contact Person (Plan Review) <br /> Descripdan of Work to Be Dane: (c��'�.� � �t G'�Lne t �Uc�L L� [o yy� ' � <br /> N�'1 N H <br /> .�. ✓ f C , <br /> V <br /> NOTE: WIRING IN NON-D ELLINGS IS RE UIRED TO FEE <br /> 8E IN RqCEWAYS, MC OR AC CABL . ` <br /> CITY oF EVERETT LOCA�5 LES TAX CODE IS 3105 /U�� �� <br /> I hereby certily that I have rea and examined this ppl7catron and know the same to be lrue and <br /> conect. All provisions of laws nd ortllnances gove ing thls type ot Nrork will be Cpmplefed <br /> whether spaci(ed herein ornot Tha grdnting o1 a rmd tloes notp resume to givg dufhoirty to <br /> violate orcancel e pravision of any ofher state o Ixal faw regu/ating construchon or the <br /> performan e o( nsuircG'on. at I am autherJzed y fhe ownerol fhis prpperty to pBrfomt the <br /> work lor�ich pplicafion i de and I camply wit the Sfete Confroctors Law 18.27 RCW and <br /> 296.200 A <br /> f � -(� -% %���° ` Da- <br /> ,� ' <br /> Sig �ate — <br /> I <br /> 2iT;abpd L588LS252bj��l 6L96ST9888 d�ll:wo�� Sb�TL ST02-90-Nflf <br />