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-- - - - -i <br /> ELECTRICAL PEI�MIT APPLIGATIaN I <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, \NA 98201 <br /> 425-257-881C - FAX47_5-257-8857 —www.everettwa.org <br /> APPLICATIO�S ARE ACCEPTED FROM 8 AM TO 4 PM <br /> L �`� 1��' �fi� Fv�v�-'-`� <br /> PRO,IECT ADDRESS <br /> `���'��� f�1t � 4 �' � ���(���'�'r� ���� ��� ����� ��� <br /> Owner��^ Mail AAdre s City tate/Lp Phone <br /> Ci� StaleQip Phone II <br /> Ten,in� Mail Addmss Y <br /> \t�J �c�;r' Fl�r�rr\ �uc� 1c��5 �� ��-- '-,+— Lc ��etru�s�'uJ c����$ i <br /> Elecirical CoNraclor Mail Addres; Giy Stale2ip ����\ q7��`PG�4e I j I <br /> J�'7� �- <br /> � h.l���(��.�j ��'j 7(�� ��3�� �I <br /> Slale License Number Conlracl Price of Work <br /> i <br /> K�,�7'1(�P�( � � <br /> Proposed Use o(Buildin � Contacl Person (Plan Review) i <br /> I <br /> i <br /> Cescription oi Work lo Be Danc: I�.�*� �'`�'�) ��^n�G�� �'IP h���I �—�`�—Q�,�' <br /> I <br /> I <br /> I <br /> — — I <br /> I NOTE: WIRING IN NON-DINELLINGS IS REQUIRED TO FEE II <br /> f BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY QF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> i <br /> I herehy certdy Ihat!have read and examined this applicaffon and Ano�v the same fo be Vue and �/ j����� (.��� � <br /> ccnecl. All provisions oll.aws and ordinances goveming fhis rype o!work tvill Ge cornpleted �1_�iJ <br /> �vhetlier specdied herein or not The grantir;g ol a permd Aoes not resume to give aufhority�o <br /> ��iolate or cancel fhe pmvisions ol any ofher sfafe or local la�v reguPfing cons Wcfion or the <br /> performance ol const�ucfion. Thaf I am aufhonzed by Ihe owner ol this property lo perform the <br /> n�ork lor which applicetion is made and 1 romply with the Slafe Confractors Law 18.27 RCW and <br /> 296.200 WAC. � <br /> , � ✓ <br /> ��, 2�1i �p� � <br /> Signalure Dale <br />