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1=eb-03- 11 03 : 32P P _O1 <br /> ELECTRICAL PEIr2MIT APPLICATION <br /> CITY OF EVERETT f'�RMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 , <br /> 425-257-8810 - FAX 425-2`�'a857 -www•everettwa.org <br /> APPUCATIONS ARE ACCEf'TED FROM 8 AM TO 4 PM <br /> ._�r_S I �7- fL LUGi' UL+�— - ! �-S� <br /> PROJECT ADDRESS <br /> ��� <br /> �,� v t� ,M� w�+6►�� iL _. �5/� ��Ur�o�' w��' �'��.�� ,z _ <br /> Owner <br /> Mall AAdross Clly Statc/Zip Phone <br /> Tonant <br /> r M1fail Address Clty Stata�7Jp Phone <br /> t� tr� S'�S 3Wo / �U � IrC/ zp.ZO/ _.^`��J" ,ZI�' .Z/¢j <br /> Y��.-. '� Phone <br /> Gloctncal Contraclur Matl Address Cily SUip21p <br /> � '� �1 K/`f'�� 7�' C 1.°�! � <br /> Slale Llcense Numbor Contract Price of Work <br /> Propo.sJed U's af Buildlnfl Conlact Person (Plan Rcvin�v) � <br /> D�+sr.ription of Work to 6e Dono: l.,� I t. C�Q�Ut_r_— -...�' <br /> _._, <br /> NOTC: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, A1C OR AC CABLE. ��, or <br /> CITY OP EVERETT LOCAL SA�[S TAX CO�E IS 3105 <br /> 1 hoinhy certl(y that I h�ve�ead�nd examinoA fh;s opplicotiun nnd rtnow O�e samo to bv iruo nnd <br /> correct. A!I provlslons ol la�vs and ordin�nces goventlnQ thls typu of work�viil bo completed <br /> whefhe�specl0ed horain oi�not The yrenlMg o/a pemut Aor.s nN �resume fo glvu nuthorffy to <br /> vlulufe or cancel the provisions of�ny ofher staf�orlocal!nw reyul3(Ing cunstnufion or fhn <br /> perlamance o/censtnicfion. Thnf 1 erit�ulhoiizOd by the owne�o(fh�s proPo�iy to poifurm fho <br /> work!or which n plication Is rnade and 1 cemply�vith the Stafe Confractors Law 18.27 RCW and D c� /1 <br /> 29ti.200 WAC. �� <br /> _ _ �.._---�3,E`1 J /d �- <br /> $ipn Fl <br /> L.-.._. . . .. ..�...__._�__�' _' _"'__— <br />