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EL�CTRIC�L PERMIT APPLICATIUN <br /> CITY OF EVERETT PERMIT SERVICES / <br /> 32G0 CEDAR STREET, EVER[TT, WA 98201 �"t��� <br /> 425-25�-8810 - FAX 425-257-8857—www.everetlwa.org �o �Q.�a a-S' <br /> APPLICATfONS ARE ACCEPTE� FROM 8 AM TO 4 PM <br /> Js;�-) Il ��� � i'��,� � ,; � � �;����/ � ��� <br /> PROJECT ADDRESS <br /> �n��c� �"�.,�„r�� ; (��;i �c� ; �—in,,,��t;;//� �I)7'�rG ��G(?-Cs3-),5= <br /> Ownef h1�il,lddress City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> ^ � , <br /> �._��,,�un� 4.,1<< ��c��.r.�:� 1��r2 ����;�u,ll��� �v:�� �;�,�7t� ��/%S��'rD-l3�fC1 <br /> Eleclrical Conlraclor Mail Address City Stale/Zip Phone <br /> ,� 5 ,' L�<'i <br /> L_C'l1i'fl(���(�1/�/i "� <br /> State License Number Conlract Price of Work <br /> S j �l��r<" �� I�l 11 � <br /> Proposed Uss of Building Conlact Person (Plan Revie�v) <br /> .. r� � l ''`.�— _� ' ,- <br /> Description of Work to Be Done: �`� C-' /I `+ !� I JQ �,{/C'�� f'fJ��� ( � /�'��� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> � BE IN RACEWAYS, MC OR AC CABLE. i <br /> I <br /> � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily fhaf 1 have read and exaniined this applicafion and know the same to be true ar�d <br /> correct All provisions o//aws and ordinances governmy Ilus type of work will be complefed <br /> whelher speciLed herein or not The c�ranting o(a pernut does not resurne to give authority to <br /> violafe or cancel fhe provisions olany other sfate or local la�v reguPlinc�conslructron or fhe <br /> perlomiance o/construc6on. That 1 am authorized 6y the owner o/fhis propeAy to pedorm Ihe <br /> work Ior�vhich applir.afion is made and 1 comply with the Sfafe Confractors La�v 1827 RCW and <br /> 296.200 WAC. <br /> � <br /> ,�'' % G 5'%c�%�� 0c'� � <br /> ; iynature �� Date <br /> ���-va5 <br /> r--', <br /> >:.� <br />