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05: 14!��13 11:S' 253-631-7754 PROVIDENT ELECTP.IC FGGE 02��'- <br /> � �I <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> I 3200 CEDAR STREET, EV[RETT,WA 98201 <br /> 425-257-8810 - FAX 425-257-8857–www.everetbva.org —_ —� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PN <br /> — <br /> � ��� � ���� W " G.il 1 � � � ��, <br /> PROJECT ADDRESS L�-t- � �=^ i <br /> �y�7zld�.�Fll <br /> �Q�,L�1�S��(��I�D�i.� po v�}c ty42� �IiU. LG�� ,4�t , <br /> Owner Mail AAdress Ciry StateJZiP Phone i <br /> � <br /> TenOnt Mall AOdress City StateJZip Phone <br /> IP��I�L�.� [• �iJL '��Dx-lOgi CDU1Nbin�1�.812�12 �r�3•u�•�7sp <br /> [IectnwlContrector MaiiAaamss Gty StatelLia anorre <br /> ; y�fL[[�'C I �?X 2 , � <br /> :itata t icense Number Contrad Price ef lhork <br /> z � <br /> � ,�2. L� �U�'��1L��_ <br /> �� � 7� _ � <br /> Proposed Use ol owiding I ' Ce ad Person �Plan Review) <br /> Descriptian a'Work to Be Done: ����C,����� � w ��� �� <br /> — — I <br /> I <br /> NOT[ WIRING IN NON-DWELLINGS IS REQUIRED TO FEE I i <br /> 6E IN RACEWAYS, MC OR AC CABLE. ,./� � I <br /> � D�� <br /> CITV OF EVERETT LOCAL SALCS TAX CODE IS 3706 <br /> I heroby cemry thaf!ha�c read end ea�amined fhrs ap�7calion 2nd kno�v fte same to te frve and L� 3 0 5 - 07 7 I <br /> CorreCt. Atl prowsrons o7laws and oNinance5 govemmg fhis ryPe o/woO:�t�ll bo r.ompleted I <br /> whetherspG�fied hr.rem ornot. The gron6np of a pemrrt docs not prosumo to give eu;honty to <br /> violate or cancel!he provisirns of any othcr'stalo or local/aw regWah'ng constrvc5un or!he <br /> perlormanceolconSWcGon. Thatlamau:honzedGyfhoownerolthrs PropeRyfopedortnNe <br /> �vprk tor whrr.h�pplication is made and I compfy witb the Safc Contlacf�rs Law 18.27 RCW and <br /> 29G200 WAC. <br /> ,� r� ___—��1,��I� <br /> 5ignawre • <br />