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I E�ECTRI�A►L PERIVIIT APPLICe4TION <br /> GITY OF �1fEkETT PE�MIT SER�iICES <br /> 3200 CEDAR STREET, EVERETf, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org (b �a.g-�S <br /> APPI.ICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CF2EDIT CARDS ARE NOT ACCEPTED <br /> I I 2 I 5 L L��r�:�� N�«I I ����.�i <br /> PROJECT ADDRESS <br /> Ci�/ O-i EvEfc}'�" <br /> Owner MailAddres. City State2ip Phone <br /> Tenant Mail Address City State2ip Phone <br /> V[ I��� � �Cc�fiL �o IIDG M�tfi�� �(Cc'�c I n/�w�/ L�z�e{'� (�A� �u�Loy �4�5� `��]-�cs32_ <br /> Electrica Contractor Mail Atldress Ciry State/Zip � <br /> \1h ��� c= L �yi�L'ri <br /> ite License Number Contract Price of Work <br /> <CG��I'�"� 1 (C:U1�LT L�t1t�UP.YICy �,'�-'S �Ci1iC( � <br /> Proposed Use of Building Contact Person (Plan Review) <br /> % / <br /> j DescriptionofWor::tcae �one: �il��l���0.�1�1 � Y �UtJ V���Z�«- �'"`��� J� ���� �'I`(�� <br /> I <br /> i <br /> � <br /> � _ <br /> NOTE: WIRING !�I h10��-���NE!LINGS IS REQUIRED TO FEE <br /> II <br /> BE IN RACE�NP.YS, N1C OF HC CABLE. <br /> i ��� <br /> y CITY OF EVERETT LOCAL SALES TA:C CO�E IS 3105 <br /> - I hereby certi"ry that I have read and exami,ved fhis sppfication and Imo�•�the aame to be frue and ; <br /> � correcL All prcvisiens of laws and ordinarcas governmg ihis type o;:��rk�.�il'be completed � <br /> jwhether speci(�ed herein cr not. The granrma oi a permit does not presu.�ne t�give authonty to j <br /> violale or cancel the provisiens ef any other st�te or local la�v regulairng ccnshuction or fhe � <br /> perfcrmance of constructicn. That 1 am autherizeC by the owner ot this property to perferm the i <br /> work ior which appGca�ion is maAe and 1 cemplv with the Sfate Contractcrs Le�w 18.27 RCW and <br /> C� � �"� / I <br /> _ �;' <br /> � c�� 2� 2�`� <br /> Sianat 2 � Da;e <br /> � ��/C /�5 <br /> ; <br />