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I <br /> ELECTRICA.� PERMIT APPLICATION <br /> CITY OF �VERETT PERMIT SERVICES <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 <br /> /�� <br /> .-���.�C� � �l.i G11 J��'� ��� <br /> PROJECTADDRESS <br /> �>� i(� ��1t� {X 7 '7����' < �� ��„o�� ��� ,C�,r..-tl— r�� i6 a�' -� <br /> Owner Mail Address City SlatelZip Phone <br /> N��- <br /> Tenan� Mail Adtlress Ciry StalelZip Phone <br /> � � LL!GS <br /> <���1� ���bS��l / .1 c,L ��1�1 /D�5% .r�r..ri1.-� L,:,��' S�P�'� �� �Jk `7Ff7S�" c.�6- 7%�- <br /> ElectnCal Conlrac�or Mail Address City�j�ln/O �� State2ip Phone <br /> {��i , �ii��2-� �/57.�5 / '','S� ' c`�� <br /> State License Number Contract Price of Work <br /> �i <br /> c .Gr �� �� - �/ <br /> � J .�ti��' �z'`t.� ,� �c`�iC �-':_,! r cbr U <br /> i <br /> Proposed Use of Bwlding Contact Person (Plan Review) <br /> Description of Work ta Be Done: .� ` ��� L"'� � ' � �'a./' •�' ��c �-,�/E"���i r Ir�C,���-1 <br /> � ��� 1 1- '� 1�. i:i'a+� . <br /> 11,� Li L � ���i �Slt<1 lJ"�';�.' �ii.:✓ �t�L� LY'��Fc� �� c�[ lPC � s- <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 3106 <br /> 1 hereby cerLly tlraf I have read and eYamined this app/ication and know Ihe same lo be true and <br /> correr.t. All provisions ol/aws and ordinances governmg Ihis type ol work will6e compleled <br /> �rhefhe• speafied he�ein or noL The granting o/a penml does not resume to give aufhonty to <br /> violafe or cancel Ihe pmvisions ol any ofher sfale or local law reguPting consWction or Ihe <br /> perlomrance ol construclion. Thaf I am airthonzed by fhe owner ol this property fo perlorm fhe <br /> work lor which app6cahon rs made and 1 comply wifb(he State Con(racfors Law 18.27 RCW and <br /> 296 200 WAC. <br /> � , --� �'.v�— ���b/�`� o <br /> Slgnature Date �O�(���- �� � <br />