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ELECTRIC,AL PERMIT APPLICATION <br /> CITY UF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX425-257-8857—www.everettvia.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEDIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> Nc�IS �-'"1�� <br /> (�3d�' /J�e r�i il � Cr�e.� �l kt�Y al�cti . /� <br /> PROJECTADDRESS U <br /> ��• <br /> �/'�- �l�i/' ![�J/ /L� 7CY�l`- S'1 � r"t�ikP C�%� "r/ '�C�l yzs zx� �)a iY1 <br /> �'�e� MaAAtldress Ciy Stete/Zip Phone <br /> ,f�„//< ��r- 1�3a 6;�s�. �c�� u.v #f- � R 9a'LC�I tizs z �0 1 mc� <br /> Tenent—� Mail Address City State2ip Phone <br /> Fre_ i rG}rc fi6�— �Nc_ /�3ti �i b'rn f l v� �P�4' Gi)t1- 9�'1��1 4 � 2 i %r. .L <br /> EledncalConlfado� MatlAddress City StelelLp Phone <br /> %!,C'Ci�1�BZ�inL— � �'ll ,`� <br /> Slete License Number Contred Price of Wortc <br /> � <br /> ��x�; 1��,�-�, 7�n,,,�s ��-ks <br /> Proposed Use of B ' ing Contad Person (Plan Review) <br /> Descriptian of Work lo Be Done: �CW l�n��G��Q �-,/L �f���,._, <br /> U <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIREDTO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> . '1Z� 3� <br /> l <br /> CIIY OF EVERETT I.00AL SALES TAX CODE IS 3105 <br /> I here6y certily that I have read and examined fhis applicah�on ond know(he same to be 6ue and <br /> coned. All p{ovisions ollaws ond ordinances govemmg this type ol worir wil!be crompleted <br /> wbether speci6etl herein or not. 'me granting o!a penmt does notpre sume to give authority ro <br /> vio/ate or cancellhe provisions ol eny other sta(e or la:al law regu/a�ing construdion or the <br /> peAormance ol cons7rucfion. Thaf I am eutlionzetl6y the owner o1Busproperty fo peAortn the <br /> work Ior which applicafion is made and 1 comply with Ihe Sfate Confracrors Lew 18.27 RCW and <br /> 296.200 WAC. �� <br /> �%� <br /> __�.��i <br /> .,��— . <br /> gnature � 1 � L� <br /> Dete <br /> � <br /> .�,—� _ � <br />