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; <br /> ii���,:,;�:_�:���� ,,.;� .��s��e����,��:�„� FaeE �2i�a <br /> EILECTRICAL PERMIT APPLICATION <br /> CITY OF EVERE�'T PERMIT SERVICES <br /> I 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAiC 425-257-8857 -www.everettwa.org <br /> APpLICATIONB AR[ACCEPTED FROM 0 Ahl TO h PM <br /> ll Z�l � Evo�-�IT k�v9-�� t,v�1-`( <br /> PROJECT ADDR[SS <br /> it Stale2ip Pnane <br /> ovmer Mnil Addmss � Y �p'� <br /> PJ9r11y d G �uE+=�c.9- //Z`I iE f�O�7�-a,aru w'*`f <br /> 38h s86r <br /> M17ailAdtlregs CHy Slatc2ip Phono <br /> Tenant �y—? <br /> 1 <br /> �}77' Xc�iiZil�Sc�'��rx3 Nf3t`/ j-'. tgz�p:� �1 $�bS" P>:ri4.�-� w�r 9c�c��i �7�7"Phonc <br /> GICclricelContraC;or MailAdtlrese Clly StatelZ�O <br /> ��Do.oJ <br /> `7� ���'�7�7J� ContractPriceofWork <br /> Statc Licenee Number <br /> r.cn ;�.x 2s'>-3 }"�-ii�.� <br /> Propoaed Use of euiltling Gonlact Farson (Plan Revlew) <br /> f 3($j17lCS <br /> Descriptlon of Work La Be �one: u�'�'/�A��' <br /> F.X�Si�nIG �� ��u�G�Yj' ; G'�rd <br /> NOTE: WIRING IN NON-D�LLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC qR AC CADLE. <br /> CITY DI'EVERETT LOCAL.�iALES TAX CODL IS 3105 <br /> I here6y cer;ify fhat I have read snd examineJ fhis appllcafion and'nnow fho same fo be We and <br /> correct. All provlsions o/faus antl ortiinricos r�oveming thls typo ol�vork wlll be complated <br /> u�hefher 5pec//ied horcin ornot The gnnting o/a pe�md tloes notp rvsume Po give aulhcnty fo <br /> viCl�to orcanrol fhe provisivns o(nny ofhersta(e or/ocaf/aiv regulatin,q conSWction orfhe <br /> porformanco o(construction. Tho1/em aulhonzod by tho o�vner o(this p�ropory fu Ferlorm ffr2 <br /> v:ork for whicb applieofion is tr70tle�r,d f eomp/y t:ith th0 Sfafo Cenlracfers Ldw 18.27 RCW and <br /> 296.200 WAC. <br /> I �� �� __ //�f�a1 i"� I <br /> S�qnature � Date � �� <br /> I �( / %� � % <br /> I <br />