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( . <br /> w°��' <br /> \�'' �`� <br /> � � ELEC'�RICAL PERMIT APPLICATION <br /> ��� ; CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org � --7-0 g <br /> APPLICATIONS ARE ACCEPTED FkOM 8 AM TO 4 PM �071��"' <br /> � I lo Pac� (,C ��� . F��=�'e t t �✓� <br /> PROJECT ADDRESS <br /> �rcv�l�^41ez Eve�u tt 13 J-t Crt b�� A�e ,:�e.�c e( �''"' R82�r l <br /> Ownet 'W�ecLcu{ CC,.Tsn MailAddress City Shte2ip Phone <br /> �AL'A(iC. l�i��r.(����� "' N�f{. IZe�vtor�S.� � I(0 �llG (i(' ��C fVCh�t�, Gv/-1 <br /> Tenant MailAddrese hh` Flec�; Ciy Shte?ip Phone <br /> t�ucic�,,, i_lcclhK, �lr�l [ Fiar��tC V�Q.� D�, LV��ti-�i W<l �i42tj <br /> Electrical Contractor Mell Addreu Gry State/Zip PMne <br /> ti <br /> r2o�hc ��cza2 Pn `�i3�' .° <br /> State License Number . Contrad Price of Work <br /> �'1EC�-�L� lLi.v�`�I i,t�lC,4_ `�(�i�.tk.� KC�II�i �.i'�C(�v �DV S;m��IW <br /> Proposed Use oi Building -- - Contad Person (Plan Review) �'�^"'`�-�1 <br /> � <br /> Description of Work to Be Done: (��u Cucu-�.� �t.ic:..�k (rr�r,i✓C�wt ..�n'� �-tC�P���z+-�' (e.iut�e-l."'CL <br /> ��QG�f('� rl�✓U��G� rncY`c c'?{fiGC.. 5(�� (�t�.'Y O( [�vl Qf�'fi.. �L`vrvieJ�1 lc.�CG� <br /> ��Z�J � n��l�(/�i �'1i'� rvti�-C,Y,ti.t�e� • <br /> NOTE: VVIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT IOCAL SALES TAX CODE IS 3105 <br /> I hereby ceRify(hat 1 heve read end exemined this epplication end know the seme to be frue and <br /> correct All provisions of laws end ordinences goveming tbis type o/work will6e completed <br /> wbether specfied hemin or nof. The grenting o(a permrt does not resume to give euthonty fo <br /> violafeorcencelthe provisionsofenyotberstefeorlocallawreguPhngconsWdionorfhe <br /> pertormance o!consiruchon. That I em authonzed by the owner o/fhis property fa peAoim the <br /> work ror w6ich application is made end 1 comply wifh the Sfa�e Conhedors Law 78.27 RCW end <br /> 296200 WAC. <br /> / ' <br /> I r��{.�: U(�a� ��'' �'���l�yC���i���ti�C1 - <br /> Signature Datc I �,� I . �% -7 <br /> 7- <br /> ,� ��� -�.�c <br /> � <br /> , <br /> �,� �,,�.�,.,. �Glo� <br />