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E�ECTRICAL �L��MIT �4PPLICATION <br /> CITY OF EVER�T7 i'�RMIT SERVICES <br /> 3200 CEDAR STREET, ��JERETT, W.A 98201 <br /> 425-25T-8810 - FAX 425-257-8857–wowv.everettwa.org <br /> I <br /> APPLICATIONS ARE• ACCEPTED rROM 8 AM TO 4 !'M <br /> ��.i7� - i-I� �t 11�� � - <br /> PROJECT ADDRE S <br /> � y.2S��zs7- <br /> I�-III� � �7C'r'111�r' � �7i-y'Nr:ti':'� - ��?� I��� 1`�v� C���'�eli W;� `��'lUl q Sl.k <br /> -� � <br /> Owner �� MadAddress City State/Zip Phone <br /> Tenant MailAddress City Slate/Zip Phone <br /> ���S ���-���� - 5��i� � 1�-ia�,,� >T l�iion�,��c� , 6�J�i- `1�t7 Z 3���e����`ty�3�k- <br /> ElectricalConiractor MailAtltlress � City StalelZip Phone <br /> ��j `�NTC�SN`�3r:�12 �� �`� 75 , <br /> Slate License Number Con ract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Descrlption of Work to Be Done: F—�1� N �, �") ��� �'1�"11� �����f LC �Z}�` � ���J <br /> ����iv �C�/� —T <br /> NOTE: WIRING IN NON-DWELiINGS I;,REQUiRED TO FEF <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES 7AX CODE IS 7105 ` / <br /> I hereGy cortily that I have read and e.eamined this application and knorv the same(o be fruo and ` � � ��-{7 <br /> correcL A!I provisions o/Imvs and ordinances�Joverning this typo o/wcrk will be comple(ed L.�' � <br /> �vhelher speciGed horein or noL The yran6ng of a pe�md does not presumr, to givo aufhority to <br /> violate or cancel�ne provisions o/any ofher state or local la�v regulafing construction cr fhe <br /> peAomiance o(construction. That 1 am authonzed by the o�vnor ol fhis property to per(orm the � <br /> work�br wbich applicafion is made and 1 comply wi(h the Sfate Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> l,�` __\ <br /> ������,.�� � ` ��,,�� ? 11 7._i:i0 _ <br /> --�gnawre _ Dale <br /> �J <br />