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ELECTRIC�L PEF�.61liIT A@RLICATIOfV <br /> CITY OF E\/IEftETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERcTT, WA 98201 <br /> 425-257�8810 - FAX425-257-8857-wwv��.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8,�M TO 4 PM <br /> /u/�� SL L.,�•��I-� /`'lal� 1�.�, �,e•�c�-j'. W�:L �j4's.'�g- <br /> PROJECTADDRESS `� <br /> C�.,�� .�V1n 1� <br /> �c� R lo�� LG G !o/U 5C•%✓e.£f�A�l i 1�k� -�ioZ c..¢. ry- Inl i1- �l ts,;�Ofr <br /> Owner Mail Address Cify SlatelZip Phone <br /> TGi/l,e.-5 .t.�, iG�ce /u/U SrC✓�•�1L GL��wky LuF�el!- l-.IA- gCT.Zah- <br /> Tenant MailAdtlress Ciry StatelZip Phone <br /> Mei� �- /V�e,.�..r.,.�����Kc �'�/� k�3'`�%...eN[_-" J�,�v�.,e� w /� �JS HZ>-5�-)Zz�/ <br /> EleclricalContractor MeilAddress �ity Stale2ip Phone <br /> M�2.�rN�y �2 iVJ ��J�' � <br /> Stale License Number Contract Price of Work <br /> �. - �%l--�i�G� �'ixr-.,�.� /l/�_��� <br /> ProposeC Use of Building Contact Person (Plan Review) <br /> Description o(Work to Be Done: _ZQ, p«.}� � LnW Vo/ n 7'�fi- t�� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAY.CODE IS 3105 <br /> 1 hereby certily that 1 have read and examined fhis application and kno�v the sarne to be f�ue and <br /> co�recL All provisions o(laws and ordinances yovemmg this fype of work�vill be completed <br /> whefherspea(ied herein ornoL 7he granting o(a pe�md does not presume fo give authonty to <br /> violate or cancel fhe nrovisions oI any ofher slata or local la�v rayula(ing„on;tn�ction or the <br /> pedormance o/corsirur,fion. That 1 am authonzed Gy fhe o�vne;o/f/ris propeity to penorm fhe <br /> work lor which appacation is made and I cornply with the Slate Confractors Law 1 R27 RCW and <br /> 296.200 WAC. <br /> r�.-:�v._%�' I oc ,, c z /z 3 /�i <br /> S;gnature Date <br /> r <br /> �.(�� � � J �-}7/ <br /> Y"' �.i �-L� �✓yt� <br />