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� <br /> I <br /> ELEGTRICAL PERMIT APPLICATIOf�1 <br /> CITY OF EVERETT PERMIT SEF2VICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -v�nvw.everettwa.org <br /> APPLICATIONS F RE ACCEPTED FROM 8 AM TG 4 PM <br /> s/��-7 �r�—gc_��-E 1�-v� _ <br /> PROJEC. ADDRESS <br /> �,..a /� �4 �... �1 0��,�, N 3 a� �c�-� l� �a.,�-1--� w�3 9 g.�-os <br /> � Ovmer �.1a�1 Adtlress Cily Slate2ip Pnone <br /> , .�e as ycp g pig,sU <br /> Tenant r.tad Address Gty StaterDp aher,e <br /> I .I I r <br /> I �r` y µ{e*�w� Ltr L�•..i ��iP i+� �O � Mn �. S� 1�01ti!`OG 'lJ�%1 � �'�7� 3� v �9�-/ •73I. <br /> ElOctriCOl ConlraGtor P:taJ AddreSs Cily SlateZp Pnone <br /> � BD <br /> I .�,.s a-I-T rr_s al 9 3 0-��' �l 1 3 r <br /> �i State L�cense Number Contracl Pnce ot Work <br /> IProposed Use of Building Contacl Person (Plan Review) I <br /> I <br /> DescnpUon ot Work to Be Done. Y!�1-S•t�-(( �` °�� �% ��c-.��A �.r,�,� <br /> i I <br /> I <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIR�D TO FEE <br /> i BE RJ RACEWAYS, MC OR AC CABLE. �� �� <br /> CITY OF EVERETT LOCAL SALES TAX COOE IS �105 <br /> I heiehy cerfdy(hat I have read and exarmned fhis applicafion and kno�v the same to Ge(nie and {- � t _ ( (`� <br /> correcf All prov�s�ons o!la�vs and ardmances govemmq this rype ol�vork nall be completetl C �� D OI� <br /> �tdiefher specrGeAherein or nof The gran(mg ola pe�md does not presume fo grve authonty lo V <br /> vio�ate o�cancel the piovis�ons ol any other stafe or/ocal law re9�Jabng consVuction or the <br /> peAormance o/construchon That 1 am aidhonzod by fhe o:vner ol fhis property to perlorm fhe <br /> n�oik Ior which applrcahon is made and!compry u�ith fhe Sfate ConVacfo�s Law 18.27 RCW antl <br /> 296 700 WAC. <br /> t <br /> I t�_u.-�-�.c�,,. � l0- io-��a <br /> SignaWre Dale <br />