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i <br /> ELECTRICAL �ERIhIIIT APPLIrATION <br /> CITY OF EVEREI'T PFRMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - f-'AX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPI'ED FRO�JI 8 AM TU 4 PM <br /> 3 a �s P��, -�C /�vE .Eve�e �f u�/-� QB �.o/ <br /> PROJECT ADDRESS <br /> n 1.� ,, / 3�9�G•3;�1/ <br /> A'1�A9✓C'�'G,l� Cc�'.S� �/S% �pN B�`�Pr� K(' Ec�PrSDY� cJF4- `� aN <br /> Own� hlail Address City State2ip Ph�� <br /> � N�S'P�rfS•Oy�� <br /> � �cn IZoG� fi�c�v�1S LLe 3���P�c�t-r� V�ve_ ��e�em��- 90� ( <br /> Tenant Mail Adtlress City StateRip Phone <br /> �Ei �'{z�y �i�EGi�L i � 4eio g <br /> �' F3�?7 5��� .�i recTo� �e�� ,$�A sT[e W A <br /> EletMcal Contrg r Mail Address City Slale2ip Phone <br /> �07.y4.5 I / �CP_i �he(? /D!$�I "�l� �a <br /> State L�cense Number Contrad Price of Work <br /> G��n r�^o✓F i�L /�hCrecJ (.c�l/— !�G%C _ <br /> Proposed Use of Building Conlacl Person (Plan Review) <br /> � <br /> Descnpfion of Work to Be Done: ,1!'1 C�e!�� S � � e rj Q rJ� C e. T'j� <br /> a�oR v8a ✓ aPt�G-�P <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVER[TT LOCAL SALES TAX CODE IS J105 <br /> 1 hereby c�rtily tha!I have reatl and eramineAfhis application and know Ihe same to be true and <br /> correcC All provisions o/la�rr and ordinances governmg thrs type o/wodc will bo complefed <br /> �vhether speci6ed herein ornd The granfing ul a pennrf does not presume fo give authonty to <br /> violafe a cancel the provisior.s ol any o(her state or/ocal law regulafing conslnicfion or the <br /> perlomrance oI construc.'ion. That I ar�aufhonzed by tho o�vner o/fhis propedy ro pedorm the <br /> �rork/or which applicalion is rnade and/comply wifh the State Conirecfors Law 1827 RCW and <br /> 296.200 WAC. <br /> _ �Zt G�'✓`�°�" aC G�.�s. (/ S /S 7�.� <br /> SignaWre Dat <br /> �d�o5-I C, <br />