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iUL-10-c00 i 11�-1� FF'L�hl:HGh1E RLPd ELECTRIC 4254B97996 T0: 14c�c5788�7 F.c <br /> ELECTRICAL PEI�MIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �_,�p —D �' <br /> 425-257-8810 - FAX 425-257-8657–www.everettwa.org <br /> ' Co �a7 -o�F.S <br /> APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM <br /> �ya� ��eur�' ��vr�� <br /> PROJECT ADDRESS <br /> `�/y,/�.1�h �if/S�ue�o/��� /d33.� 6 S��' �/ Gf� �/l,�i/r�o �' �S- <br /> Owflef fdail Addmse Clly Stete2lp Phone <br /> Tenenl Moil Address Clly Slatc2lp Phane <br /> �ame ��✓�/cT,�r� LL� /�o 'a x z�� �/ /,//A� q�o5q-o� / <br /> EiecMcal Contrector b7all nderess Clry Slate� ��s PJ!o� a7 / <br /> Y <br /> �an���P� 9r��� �'�, rr�n i <br /> Stale Liconeo Number Conlracl Price of Work <br /> �e�uJ q �L��i � P _ _ � � L�l� �-�7h iTff <br /> Proposed Uso of Bu' Ing '� Contect Person (Plan Review <br /> �-nd_ � o —�--5`O/ <br /> Descriplion of Work to Be �one: �/��L ��. G� W ����� �-D 9/`�"�_� <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 9105 <br /> I horoby certily that I have road and exomined thls opplica�ion and know the samo to be troe end �C/ O�_C}.`� <br /> corrocL All provisions of lans and ordinences poveming htiis typo of work wi0 be camplofed � <br /> whafherspecified heroin ornoL Tbo grenfing of a permrt does notp resume to give aufhonry to <br /> violafe or cancel the Provisions ol any ofher stafo or local law rogu/oting construcfion or the <br /> perlormance o/construclion. That I am authonzed by the o�vner olthis proporty to perlortn fhe <br /> work/or whfch appl�r.�fion is made and 1 compty tvi(h!he Sfate Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> l�! n . i .`n �C�7/J Q��l / �/Q ��/ <br /> 19f101Uf8 03�C <br />