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Se� . l3• ?006 12:O:P61 TECYIJh SYSIER!S IIJC � IJo. 9?60 P • I <br /> . ELECTRICAL PERMIT APPLICATION <br /> � CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA P820'I <br /> 425-257-8810 - FAX 425-257-8857--www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO d PM <br /> 1 _ o�C�a�� � � 8 � � <br /> ROJECT ADDRESS � <br /> �� D� d f �d?J <br /> � d �� <br /> wner ' � Mail Addreae - City •Slate2lp � Pnone <br /> Tenant Mail Addre:s Clty . State2lp • Phone <br /> � �h na S�-1� 1��1� �5��.� � �1 �m�Z�a►�I�vl �� 9ga��� <br /> Elec:,-icai Conlraclor . Nall Address Clty SWtBlZ!p Phon� <br /> �1 � �-i N� . �7d� . �ro <br /> State Ucense Numbe ontracl Prica of rk <br /> . /!/ . � <br /> Proposed Use of Bullding Contact Person (Plan Review) <br /> � <br /> Description of Work to Be Don <br /> �.aw l� � ' <br /> NOTE; V��IRING IN NON-DWELLINGS IS REQUIRED TO • FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY oF EVERETT LOCAL SALES 7AX CODE IS 3105 <br /> �her�hy certfty that 1 heve read and examined thls eppfiCatlon and knov�thB Seme to De true end <br /> corr�cL All provlslcns o/lews and ortlinenCes poveming ihls type ol work W!!I be compieted <br /> whether spec/lled hereln or not. Tha grentfng of e perm7f doos notp resume to plve euthortty to <br /> vlolate cr cancel the p,rovisions of any othersfate arlocalle�vreguledng construc6cn or fhe <br /> perlormance cl ccnsiructlon. Thaf 1 em suthonzed 6y fhe ormer of lhis roperty to perlorm the <br /> wcrk for whlch applicat/on is made end 1 compty with the State CCnf2c ors Lew 16,27 ACW and � <br /> 295.200 WAC. � . � !, <br /> �' 1 a �da� - l <br /> . �gn ,uro � �ate � <br /> ' � ' , <br /> �� � ��-� y�•�S - ��3 �� LldS- �'-� �o . <br />