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g _ <br /> ELECTRIC/�,L PERMIT APPL�CATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 1/ - j _ p� <br /> 4�5-257-8810 - FAX 425-25'7-8857 -www.everettwa.org /G�l ��` ��3 <br /> L <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> l� T ' �✓ � ' �\ -- <br /> PROJECT ADDRESS <br /> .-r. � ;� <br /> Owner M1fail Address City StalelZip Phonc <br /> �l�f"�L'1,��•:x�_ ����-r,�s�✓t.��r� �� � ��� — <br /> Tenanl Mail Address Cily SlatelZip Phone <br /> �'�x ��-s`���._�1 r ��� �'�n�__�a 1•�t,l�•x��r"l ���,`�2�� �.�-���-\-` �r <br /> ElectriCal Contfaclor Mail Address Clly Slate/Zip Phone <br /> � •� �, <br /> '_�-"-,� �C��4;�\l_ �.. �� <br /> Slale License Number Con�rac Price of Work <br /> � <br /> �� ��J ifl .��Gt`��) �r�, '� �CS2_� <br /> Proposed Usc of BuiWin� Conlact Person (Plan Review) <br /> Description ot Work to 6o Done:���;�\ �F��� $ �7cl�l�t� 1� �K7>.J <br /> ^l�� (�� <br /> Yc ""'l2� <br /> NOTE. WIRING IN NON-DWELLINGS IS REQUIR[D TO FEE <br /> B6 IN R4CF.WAYS, MC OR Ar CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> � 1 he ;by certify Ihaf I have read and exarnined fhis ap/�lication nnd know(he same to be true and <br /> corracL All prov�sions ollatvs and o�dinances overning this type o/work�vill be comp/efed <br /> whether specdicd herein or nol. The g�antiu_ �a perrnd dnes nof ��esurne to give aufhonfy to <br /> violafe or cancef the I�rovisions o(any other� Wle or Iecsl law regul<�ting conshuclion or fhe <br /> perfo�rnance o/censfruction. That!arr nu iorized by fhe owner oI this property to pedorm fhe <br /> work Ior mhich application is made and l,comply�rifh thc: Sfafe Contracfors Law 78.27 RCW anA <br /> 29G.200 WAC. <br /> � -� - %��� <br /> �-- ' ,- -' i/ <br /> ;f,._—= 4\ J��� � <br /> — . � - c <br /> ---5'rc�natOre ,,,.- Date ,__ <br /> ' �t 1 ''.^ �� �,L 7 <br />