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� n - �i- �,�, <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 420-257-8810 - FAX 425-257-8857 - www.overetlwa.org <br /> APPIICATIONS ARE ACCEPTED FROM fl AM TQ 4 PM <br /> '31�; � ('�i>� „ � l:�.I <br /> PROJECT ADDRESS <br /> �� -fl ''>�� !- C�;•��„� 1'-i. L�el� l � 6ti�ia `���:JC1 35u �b'`� � 3i1 � <br /> pyypg� Mnd AAdross C�ry Slnte2ip Phone <br /> 7 i � ',��� E. L''�,`��„� I��. ��z�eff h�� ���'7Q� ,�,u �IK��-33a ► <br /> Tenant A1ail Addross city S�ntc�z�p Pnnne <br /> �/��l�.i,�.r� , ,. ,r '� iv ,;�; ;,� q�c,,� 7��,/:1,;, t>i' �i �c(r a � �03 �f,,� G �_l� <br /> EIBC1fIC81 On�faClol Mad Addmss City SITIeIZip Phono <br /> `/outi�` � �y�<:r b,��, 00t; _ <br /> State License Number Contrecl Price of Work <br /> �� � -Tl�«<� F;rk �,,5 <br /> �����,t�c- i � � �r, <br /> Pro�osed Use of Building CoMacl Person (Plan Revlew) <br /> � <br /> DescnplionulWorklo�oDone�. ���Y���e � ��� ��� �1`- ��- n. ��T ( '� �n���' � � � ' � �_ <br /> �^ <br /> �1 �-t' (� ( �' �� �1 �� � U11'1 �'lti � t" h L�Q � � .�1 ��1'l . <br /> NO"i E: WIRING IN NON-DWELLINGS IS REOUIRED TO FFE <br /> B[ IW RACE`.��AYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 heruby certdy �hnf 1 havo road nnd examined fhis app6r.nhon enA know fhe samo to be hue anA <br /> conrcf. All provisions nl lews and ortiinences,qovemrng Bris typ�ol work will be completed <br /> wh�>fhor spoalieA herta�n or nof. The grnnhng oI e pemut dces nof presume fo give aufhonty fo <br /> violafe or cnncol Ihe p�ovisions ol eny ofher state or locol law rogulaGng cnnstrucfion a fho <br /> perlormence o/construchon. That I em euthonzed 6y fne ownrr ol this p�operty fo peAorm tbe <br /> work lor which applrcefirn is made and 1 rompty wifh fhe State Conhactors Law 78.17 RCW and <br /> 29ti.?00 WAC. <br /> i / . <br /> � ;��� ,� ��i� '1��`�� 4� -- <br /> 5� D�te —_ <br /> tl�f(, 12: <br />