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. <br /> EL�CTRICAL PEI�MIT APPLICATION <br /> CITY OF EVERETT' PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 96201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM S _� � -G 7 <br /> j�" /��an, ,, 7� s� ���.-r�Y���,-,�; ����Qy n�� <br /> PROJECT ADDRESS �j <br /> C��{�'J J�h�l���<� <br /> i <br /> �t.-�4:��sfi �ti�.;�::s �'-(! 1 ���� ii;.rl_�'�, �:.��r :�� ��,✓�,,,�/��-.J, c,�? 92�E� <br /> � <br /> Owner' Mail Addross City State/Zip Phone <br /> / .�1 . I r �Fr- �-Zt;M�� <br /> Ten2nl Mail Address Cily State.2ip Phonc <br /> �� q p � <br /> � G � <br /> _<"_ �'+'JL�1�l Q�'l� ��(` 'Ll� � ' �t�U-1, '�OJ�� <br /> EleCtriCdl Conh clor M1qail Address Cily Stale/Zip Phone <br /> �i.X�G_.�_6 C7 <br /> Slate License Number Co1nlracl Price of Work <br /> I �J�:������4 <br /> j Proposed Use of Buildin� Conlact Ferson (Plan Review) <br /> i <br /> �escriplionofWorkto�eDone: 1✓`sT �1 �✓r /�Icvif SVs�v�� �f-(pr�,/S�✓�(Y ; s �fr ���i� <br /> l /� r / L <br /> �-,•�,�( / _ �in�nc�' 'f"t, i/',A�-�"F/n,✓ rwltc�.rs 3 i�a r�� Svhol�(c- cJt'-f�rJV'✓s <br /> �r�;.�;c��d ��.i 6'�r.:n <br /> � NOTE: WIRING IPJ NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. /�;L/ <br /> ,u <br /> CITY OF EVERETT LOCAL SALES TAX COUE IS 3105 <br /> I hereby certily that I 1 rave read and examined fhis application and know the same to br. frue and <br /> , correcL All provisions of/aws and o�dinances govemrng lhis type o/u�ud��vill be completed <br /> whether speci6ed he,ein ornoL The granting of a pernuf does not presume to give aufhonty fo <br />�'� vioiafe or cancel the Provisions ol any ofher slate er local la�v regulating consfrucfion or the <br /> performance o/cons(ruction. That 1 am authonzed by fhe o�:�ner o/this property to pedomi the <br /> �vork Ior�vhich applica(ion is rnade and I comply with tl ie State Contractors Law 18.27 RC W and <br /> 296.200 WAC�'J , ;! <br /> / J / <br /> � �� - > � / <br /> �� ' � , % � c� � - z <br /> ��.,� U ti .5 � <br /> ( . " SignaWro Date .�"]��� <br /> � <br /> i <br />