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ELECT��y'AL PEF�MIT APPLICATfON <br /> CITY OF EVER�TT ?ERMIT SERVICES <br /> 3200 CEe -,R STREEl =VERETT, WA 98201 <br /> 425-257-8810 - FF;X 42���'-8857 -www.everettwa.org <br /> APPLICATIONS nRE ACGI�'TED FROM 8 AM TO 4 PM <br /> �-`7 L'/ � v",��'��;�,ui L��, t' c��% �/� � S � �—u f� <br /> PRQJECT ADDRESS <br /> �-z.<��til L_�:-c_,���� ��92�,..� E_„ " . - �'/i�/3 u��i ��� <br /> � <br /> Owner � Idail Address �'' Zip Phone <br /> -i ' � � <br /> .�i����k{�t�� f ��-1. ! "- i � ��: ��y 7, � <br /> Tanant � �daii F,d•.". — f Clly gtai� . Phonc <br /> –� <br /> �� <br /> I��TL/����. _��G �,�� :�°_��';..���-�_ _.. ._`__,ff�_,./>.:•._ i`'11I1� �'r3 n3� <br /> ElrCtriC;ll Conlr.���.b. �. plail Adaws �II; � Stale2ip Phone . <br /> .� ; ��� i�=�; ��i,-�= <br /> � ��� � �� <br /> Slale License Number Conlract Price of Work <br /> Proposed Use of Building Conlacl Person (Plan Revie�v; <br /> Descriplion of Work to 6e Done: �� �x !LL� � Y' ��� /�S � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> f3E IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereb}�certily thaf 1 have read and exnrnined this ap�lication and kno�v the sarne to be fruo and <br /> correcL All provisions o(laws and ordinances governmg this typo o(�rork will be completed <br /> whefher specilied herern or noL The granting o(a pernuf does not presume to c�ive aulhonty fo <br /> violale or cancel fhe provisions of any ofher stafe or local lou�regulpfing construcfron or the <br /> perfomiance o/conslrucfion. Thaf 1 am authorized by the owner o/fhis property fo per(omi the <br /> �vork lor�vhich application is made and i comply�vifh the Stafe Contracfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � / � � <br /> , , <br /> - - , <br /> ; � �.,:�.,�.�� �.�.��_ �_��._r� ��(�3 <br /> � Signaturo � Da�o <br />