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�-----� — • - -- --i <br /> I <br /> ELECTRICAL PERMIT APPLICATION i <br /> C1TY OF EV�RETT PERMIT SERVICES � <br /> 3200 CEDAR STREET, EVERFTT, WA 98201 <br /> 425-257-8810 - f'NX 425-257-8857 —vrriw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM U AM TO 4 PM <br /> � <br /> I <br /> i _�_11 �- LO►'Y1 <br /> PROJECT ADpRESS <br /> � � ' 0. � l,e i P� �'-- �a� � � ��� . q I g,`—]'� <br /> � Owner M1!oilPtlere�s C'ty Sta!e2�p °ho�e <br /> I ienant �,�aindCreas I <br /> Cify StalelZip vhone � <br /> �1�.���.ti1.�n �' �-kt �'�1 �1�0 i 5 I ��' Q� `'��-I�. L,Q.,�C� � �1(� � <br /> Electrlcal ConVattor MpilAGdress Ci�y Stalel2ip aC� . ay �' PPo�a <br /> �� Ci� <br /> � ���'�� �( �1 2l� 7�t Ce G�t�) ��_O <br /> ( State License Numb�r Contract Pncp of Work <br /> ; _�__Q._]�� ��— _ �.;, m.i-e._ <br /> Proposed Us::a(g�ild�ng Cantad Per,on (Pion Review) <br /> I Descnption of Work to Be Done: --{' v <br /> � � <br /> I ' <br /> _. — —- --� ---- —_ i <br /> ' NOTE. WIRING IN NON-DW[LLINGS IS REQUIRED TC FFE -' I <br /> B[ IN RACFWAYS, MC OR AC CAB�E. ,_,D a rj I I <br /> � r I <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3106 ___ __� I <br /> 1 herrby c�Krly IBaf 1 hova reod and oxamwetl Nis epP�icatron and know tho sams fo be true ana I <br /> cormcC A!!pmvlsions oflaws and omrnances yavammq fhls type of�vorn will b�complofop i <br /> �vhether speciliod horeln orr,ot Tlie prenfiny o/a penli,l doos not r�sumo to grve eulhonty lo <br /> violafa or concol fho provismns of any ofho�alofo orlotallaw�roguPhnp conslnrct�on or�ho � ��I I ' � � � � <br /> porlormance of construclion. That 1 am aufhonzod by lne owner of this property fo porfortn fhe ; <br /> �vor lor u�hicb appficahon rs mode nnd/compty wiG� tho Sfafe Cun7acfors Law 1B 27 F.CW and <br /> 2 . 0 WAC. <br /> / <br /> � � - � i � aa fa <br /> Sl9natute D.te � <br /> I <br /> a,� <br />