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-� - - _ _ <br /> E'LECTRIC/�L. PERMIT AP�LICATION <br /> LITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, Ve�A b`8201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT &CREDIT CARDS ARE NOT ACCEPTED <br /> I ';�,r_% i y�1�4�iy ST <br /> PROJECT ADDRESS P <br /> Owner Mail Address City Slate2ip Phone <br /> M�,u��i �l� a.��eina��r�,l --- <br /> Tenant Mail Address City state/zip Phone <br /> � � �-e�� � " /e�e�no�a9r�'Al( � ��OS //� � S`fS(�. �.v.�rvc�o� Inl/�- G�%�0��,� �/�S �iy-l� � � <br /> Eleclrical Contraclor Mail Address City Slate/Zip Phone <br /> —ri/ � � _I Ai`��I Il, �oC� 00 <br /> Stale License Number Conlract Price of Work <br /> ProposeC Use of Buildir., Conlact Person (Plan Revi2w) <br /> Descriplion o(Work to Be Done: _l�i <I:.�� �_7�/ %;a- (,� /�h�F S �(�., �� laC�-_"ri�F,�oi S <br /> NOTE: �VIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> GE IN RACEWAYS, MC OR AC CABLE. <br /> ' CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily that I have read and examined fhis application and know fhe same to be true and <br /> correr.L All prov�sions ollaws and ordinances c�ovemmg th�s type o/work�vill be completed <br /> �vhefher spea(ied herein or nof. The granting o/a pe�md does nof presurne to give auf!ionty to <br /> violate or cancel fhe p�ovisions ol any otherstate or Iocal law regu ating construchon or the <br /> pedonnance o/construction. That I am aufhorized by the owner el this prope�ty to per/onn the <br /> work(or which application is made and 1 compty wifh Ihe State Ccntraclors La�v 18.27 RCW and <br /> 290.200 WAC. <br /> I �� i�,�—�_ !, �'•j—;J C <br /> ' '- <br /> �gnatur� Dale <br /> i u �S ��� � � �� <br />