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( ' . <br /> ELECTI�ICAL P!�RMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES 9,��.��� <br /> 425-257�8810 DAFAX 425-257 8857�www.eve ettwa.org L w�t D9 �°� <br /> APPL ICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> z � � P�c�� s � � <br /> PROJE TADDRESS <br /> `� 06�9��^ 78�8 <br /> 'nGf�i� S'��c�H � 82 c - 2`1 �� �� �l�`12��`�'7 �w A �BLo�' <br /> Owner Mail Address City SWte/Zip Phone <br /> Tenant Mail Address City StataZp ^ Phone <br /> ,1,5'3 3 3� <br /> �nLv'(��o� cNFl�l�2-• Izt�q- �i. 2��'F� kEN1 W� .S`'l�a� <br /> Eleclfical ConUaC�Or Mail Address Clty State/Zip Phone <br /> � OZ -7�? - Oi � � _� 0 � <br /> Stale Lfcense Number Contract Price of Work <br /> � �� �)c�-�, o z�S3- 26�- Sl �: <br /> Pro�osed Use of Guildfng Contact Person (Plan Revfew) <br /> Descriplion of Work lo Bo Done: �iY � R��Y h P0.1 ev , rnin o,r �y��1 a'�� • <br /> s+�� . (� I�,tA tr }�.^ n '�P✓1" iC' - ----- — <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily thaf 1 havo read and examined fhis applicafion and know the same to be frue and � � � �1 <br /> correct. All provisions o(laws and ordinances goveming this type o(worlr will6e completed W �, (� � <br /> whether specified herein ornot. The granting of a pemut does not presume to give aufhority to <br /> violafe or cancel flie provislons ol any oflier stafe or loca/law regu/afing consfruction or the <br /> perfomiance o/construcfion. Tl�af 1 am authorized 6y the owner o(fhis property to per/orm the <br /> work lor whfch applicafion is made and 1 comply with the Sfafe Confrec(ors Law 18.27 RCW end <br /> 296.200 WAC. <br /> o/J,� � /�, ���02 �;2D �� <br /> Signature Oale <br />