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— --� <br /> EL�CT�'.ICAL PERMI.T AF'PLICAT{OfV <br /> ClTY O� EVERETT P�RMIT SER�/ICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � � � ,�G <br /> i % <br /> c__— <br /> ��� �V �� � ��. 1�� � � C�C ✓ � <br /> PROJECT ADDRESS — G � a S d'�� <br /> % � � � <br /> � C��-��V '� t C�t.� i�� � � — <br /> Owner Mail Address Ciry SWle2ip Phane <br /> .f^ <br /> Tenant Mail Address Cily Slate/Zip Phone <br /> �'_ �c;�K S ���C ; ��I .�5`U�s� /J lv" S���n�:,/o�.� kJ�� <br /> Elechica�Coniraclor htail Address Cily State/Zip '7/ Ph/o�Pne <br /> Jt���� lJp J �� <br /> � L��� C1- o� l` ,� % �/S c�, � <br /> Slale License Number Contr cl Price of Work <br /> /c'i p � � � �r5 , <br /> Proposed U e of Bui ding Contact Person (Plan Review) <br /> Description of W rk lo Be Done: ��v m v��r U �� �- � <br /> � c' �C ��� •- �rs�, — <br /> 'i <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEVJAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE!S 31�5 <br /> i� 1 heieby ce�fily fhal 1 have�ead and examined this appGcatipn and knoiv the same fo be tiue and <br /> correcf. Al!provisions o/laws and oidinances govern:ny this type o/n�ork will be completed <br /> �a-helher spec7 ed herein or noL ihe granting o)a pernuf does not resume fo give authonfy fo <br /> violate,or canc I Ihe provisions oI any ofhe�state or local la�v reyuPting consVuction or the <br /> pe�lorrnance o onstruction. Thaf 1 am� fhorized b}�Ihe owner o/this property to peAomi fhe <br /> worka^or which pplicafion is made and.!�jKi/dplY�vifh fhe Stafe Contracfors Law f827 RCW and <br /> 296. 'q00WAC. � ;:� ; / <br /> � '��� � �� � � � <br /> . � - �i �� <br /> Signalure Date <br /> 1-�_���i;5-c�a 5 <br /> I <br />