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ELECTR[CAL PERMIT APPLICATION <br /> CITY OF EVER�:.=TT PERMIT SERVICES <br /> 3200 CEDAR STFcEET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 475-257-8857 —www.everett���a.org <br /> APPLICATIOIJS ARE ACCEPTED FROM 8 Atd Tl� 4 PM <br /> ,n <br /> i ��� ��� i-��� �yT <!�'� <br /> PROJECT ADDRESS <br /> i ' <br /> / � t �� <br /> OWner A1all Adtlresc Giry Staic:�Zip Phone <br /> Tenanl A1ail Address Cdy� Statc2p Phonc <br /> /t .r• .. <br /> U LJ S(1g J�� � <br /> <� ,M,M>> E��-r��� �^�3 '�-6i`��ST' Nw S��C�oo� w� �,�2�2 <br /> Eleclrical Coniracto� Mail Adtlress Ciry State2ip Phone <br /> `�L)�s�fd1�C1(" (�Z.. <br /> Stale License Number Conlracl Price o(Work <br /> (a' )�� F X -- <br /> Proposed Use of Building Conlacl Person (Plan Review) <br /> DescriplionofWorkloBeDone: I'���-C N[W �U�L�-Y �� ���� S`- IZU_� <br /> tJOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABI[. <br /> CI7Y OF EVERETT LOCAL SALES TADC CODE IS 3105 <br /> � 1 hereby certily(hat I have reaAand exomined this applicaticn and know fhe same ro be 6ue and <br /> conect All provisions ollaws and oRlinances go��emmg fhis fypo of�rork will be completed <br /> �shether speufied here�n or noL Thc granting nl a perrnd does nof presume to give aulhonry to <br /> eiolafe or cnnr,el Ore provisions o(any other sfafo or local law regu/efing construchon or fho <br /> I performanc�o/construction. Thaf 1 am aufhonzeA by the owner o/this propert}�to peifomi fhe <br /> �ro�k fo�which appliwfion is made and 1 comply�vifh fhe Sfate Conhacfors Lew 18.27 RCW and <br /> 296.200 WAG� <br /> �f � � � � � 'i— Ir �/ <br /> Sic�nature Date � % <br /> ��,� , <br /> � <br /> - --- -- - � <br /> --- � � <br /> ��� },.. - - <br />