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ELECTRICAL PERIVIIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98'l01 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> (ll��'% �'.� . .vP �=�; C� (�.l:a .� (3 <br /> PRO,iECT ADDRESS <br /> C�o��IP � iJVP �:�i_l_I t, /F'i�f LL�4/+C',,:_� � ��,�ui ��" Q,r', 7 �OL : 7� �'17��� <br /> Ownef 1.7ai1 Address f� Cily Slale,'Zip Phone <br /> Tenant Mail Address City Slale/Zip Phone <br /> �/arn� �-/o , c: y0 11 S T /�7�9�,�s?Sir� �f l.(k S'y 7 s�, yJl 3 3S 7L• cc <br /> Eledrical Contraclor A1ail Address Cily Slale/Zip Phone <br /> l�Al'r✓�[.� 97Q �1�6 �FI.f70U <br /> 5late License Number Contracl Pnco 01 WorY, <br /> Proposed Use of Building Conlad Person (Plan Review) <br /> Description oi Work to Oe Done: �U�/�L' /�(' (A) �U'��-S� <br /> IJO1 L=. WIRING IN WON-DWELLINGS IS RE�UIRED TO PEE <br /> B[ IN RACEWAYS, MC OR AC GABLE. <br /> CITY OF EVERETI'LOCAL SALES TAX COGE IS 3105 � �.��C� _ I `, <br /> � <br /> 1 hereby ceriily fhaf/have irad and examinv„'fhis application and kno�r the same to be true anA <br /> correcL A/l provisions of/aws and ordinances goveming fhis type o!work wil!be ccmpleted <br /> whether speciGed herein or noL The granfing ol a pernut does not prnsume lo gi��e authonty lo <br /> riolafe or cancel fhe �rovisions ol any other sfafe or local la�r regulafing construction or fhe <br /> perfonnance ol cons�nicfion. Thaf I am aufhonzed by the owner o!this property fo pertonn fhe <br /> work lor which applicafion is made and 1 compl���vith fhe Sfate Confiacrors La�v 18.27 RCLN and <br /> 296.200 WAC. <br /> ��� 9- / 7-48 <br /> — � - Stiqnalurc, Uate <br />