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�- <br /> ELECTRI�AL PERMIT APPLICATION <br /> ClTY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 { �- ���� <br /> 425-257-8810 - FAX 425-257-88E7-www.everetlwa.org ��p0 / -O�� <br /> APPLICATIONS ARE ACCEPTk�D FROM 8 AM TO 4 PM <br /> r.- <br /> � ivv� _ � �� � �J� <br /> PROJECT ADDRESS <br /> '�`�id ' - \<`'Lf1`� ��t 7 -� j I �. ii..���1 I �� lh �� ' .'� _�1��7 L.I.Y�i �L� . . i <br /> Owner � A9ail Addmss Cily StatelZip Phone <br /> Tenanl I,Liil Address City Slate/ZiP Phonc <br /> �' ,... �,_ : I f=-lN'.�Gi�_ rti% c� iS c (—n"A-�� ,�„_ ti1411 ��� i�u.£- ��'i � "'�-� <br /> Electrical Contrac�or AtmI1�Jd�ess City SlalelZip �/?s ?.��iSP��}"y <br /> ,• r l .- t ( '�� ' +j1� �.�I� L+^..�-L <br /> Slale�LicenseNumbcr �^ <br /> Coniracl Price of Work <br /> _����_� � - -./_ � <br /> Proposrd Use ul 13uldiny Contact Pcison (Plan Review) <br /> DescriptionofWorkloLcDorn.,� __j:. ��z�.�; t '� ., ,-� �,�_��. -�:-rTt: ,�-� r.� ! � .� 2=- <br /> J.a'ts 1�� i'.'� �� , ;i �,1,::. 1� /� /��v 1 �1 i - ( t l� ��r� �(� 1 rt'-- � <br /> _r.�,�_�: r"� � ti= Y .-.i �(� ' � <br /> NOTE: WIRWr, IN NON-DW[LLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, h1C OR AC CABLE. <br /> I CITY Of EVERETT LOCAL SALES TAX CODE IS 31;15 <br /> I <br /> d I hereby cerfily tl;aU hare roud cind exarnined this applicafiyn and hno�r fhe sarne to bu 6ue miA '� 1�1,/-1 j _ U 1 � <br /> -) correct. All provisions o(la�rs and ordmances go�ernnig thrs f}�pe oI u�ork rrill be contplefed �i \ll,' <br /> irhether spca6cAhcrcin or noL 7hc�rantirrg nf a p_mut does nof ireswne to�ive nuthonty fo <br /> violafe or cruicel t6e previsions oI ar+y ofher stafe o�locaf loa�rc�ulnfing consWctron or fhu <br /> I perfonnance oI conslruction. That I am aufhorized 6}�fhe o�rner ol this property fo peifonn the <br /> � �rork/cr�vh;ch applicafion is rnade and I comply wifh fhe Sfafe Conhactors Law 18.27 FCIV and <br /> 296.200 IYAC. <br /> � 1 <br /> ', ^ � ---___ _ r <br /> l Si a�ture p lec-� . I . � ______ <br /> \1 <br /> - - <br />