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Jun • ,`�• '_)Op6 3 � I �PI�1 IECHIdA $YJIEI'S IPlC IdJ•6322 F'• 1 <br /> ( <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET., EV�RETT, WA 98201 <br /> A25-257-8810 - FAX 425-257•8857—www,everettwa.org <br /> APPLICATIONS ARE ACCEP7ED FROM 8 AM TO 4 PM (= C��C'? ;; '-C' S� <br /> 14b1 Mer�► �1 e -��, �°•'° � � �� <br /> PROJECT ADDRESS � <br /> �=�i��irv�• � �I �1�16�2�'� � r�7n,O�nUI?G,u C�! �� I Z( <br /> OWnBf 1 Mall Addresa Clry tatelLp phone <br /> Tenent Mail Addresa Clty 3Wte21p • phone <br /> i P r��U Sc�4 ,���L<< I?J—FZ �z'�'�t �'�, �PMB�?�1L (�/1� � <br /> Electdcal COntractor Meil Address Clty p Ph e <br /> � ��SZ��`•' 360•(�S�j�Z�(� <br /> �.�� N �" 9�,4�V l� _�� <br /> Stete Llcense Number Contract Pdce ot Work <br /> J�(jy�,�] � r{�IU <br /> Propased Use of Bulldipp—' ' � Contact Peroon (Plen Revlew) <br /> Description of Work to Be Done: �' rm <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE r) / <br /> BE IN RACEWqYS, MC OR AC CABLE. � <br /> CITY OF EVERETT LOCAL SALE9 TAX Co�E IS 310b <br /> 1 here6y certl/y fhat I have read end exemined fhla eppNCOtion and know the Same to be frve 6nd <br /> congct. AI/provlslon5 0(laws and ord/nances povemin thl9 type ol work wlll be completad <br /> whether speci(ed hereln or not. Tho granNng of a perm�t does notprosume to glve authorlry to <br /> vlolate or cancel the provlsions ol eny other stete or Iccal law regulatlnp construcNon or tHe <br /> perfcrmence of ccnstruct/on. That 1 am authorized 6y the owner of thisp roperty to perlorm the <br /> work!cr wh/cl� pplicat/an Is made and I comply wlth fhe State Cont�ac(ors Lew 18.27 RCW end <br /> 298.200 WA , <br /> �� ��5/zot� EG�c� �3�- <br /> cnawre ate ' <br /> ��Z ' �u l ) -�►� C C f.x�r�f' , <br /> b � � ?� <br />