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ELECTRICA.L PERM�T APPLICATION <br /> CITY OF EVERETT PERrJIIT SERVICES <br /> 3200 CEvAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 A�7 TO 4 PM <br /> l -�,? C=,-�zfk'i� <br /> PROJECT ADDRESS / <br /> t/2 f=S.�: <:�= ) <br /> J��-,,., C-c�' ;.J �s� c� C�uLS � EVrx�c�'/'� (,,,Ifi 95�� <br /> Owner Mail Address City Slale2ip phone <br /> Tenanl A1ail�ddwss City Slate2ip Phonc <br /> �L'/A.� liC�/ � <br /> EICG�ric�l Conlraclof L1oil Addmss Gty Sla��•21p Phen� <br /> Stale Licanse NumUer Contract Prir,e of WorY. <br /> Proposed Us�of 6uilding Contact Person (Plan Revicw) <br /> Description of Wo�k lo Oe Done: <br /> NOT[: W IRING IN NON-DW ELLINGS IS RE�UIRED TO FEE <br /> B[ IN RACEWAYS, MC OR AC CABLE. <br /> /�O <br /> CITY OF EVERETT LOCAL SALE3 TAX CODE IS 3105 , <br /> 1 hereby cortily Omt 1 have read m�d examined fhis npplicafion nnd Mio�v fhe seme fo be hue and <br /> co�roct. All provisions o/la�vs and w�linances�overning fhis fppe ol�rorh will be comp/eted <br /> whefher speci(ied herein or noL The�rantin�o(a perrnd does not �resume to�ire authoriry fo <br /> violate or cancel the pro��isions ol any o�her sfate or locnl la�v rac�ulnting consVuction or the <br /> peAonnance o/consGuction. Thaf I am authori:ed by the o�rner o!thrs propert}�fo perlurm fhe <br /> �vak lor�vhich applicafion is made and 1 compl)"�rith fhe State Cenfracfc:s Law 18.27 RCIt�and <br /> 2��2oa,�P�. �—"/�3-o7.S' <br /> I � 11 <br /> ,\� '1 ii� <br /> �� L"' , �� ,`L-• � IS - r� - <br /> Siau.duie � Dale <br />