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�;-,�, � 3 2 s8c <br /> �, <br /> ELECTRICAL PFP.MIT APPLICATIC�N <br /> CITY QF EVERETT NtRMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 // a�_�j $� <br /> 425-257-8810 - FAX425-257-8857 -www.everettwa.org C� o����IS <br /> APPLICATIONS ARE ACCEPTED FR6M 8 AM TO 4 PM <br /> n „ <br /> . � � : �. �� �� _ �-�l � ' � �� �/ �'�Vl �='�i <br /> PROJECT ADDRESS <br /> _ r �yZy) <br /> J;�� v�m � ; ,, ��� � " � ,�,�� ��E :'El:� �,,�, ,,;:_ z5& -'YB l <br /> Owner Mail Address Cny Slate2ip Phone <br /> �7n F /�5 ,�>a�fiEi' <br /> Tenanl Mail AAdress Cily State2ip Phone <br /> ` , - , � <br /> /v"<S� <br /> �� � �l 'S irNEt� ��' 7T Fv'EdEf7 �fl i� /��i �5�' lf� <br /> Eledric 'ConUactor Mail Address Ciry SlatelZ�p °hone <br /> �'�:5 ��� <br /> � -=�,r: ��� - �.i�j� ��� ���� , <br /> State License Number Con�ract Price of Work <br /> .-. ;l <br /> /`� '�' ,�..� _ i �f1v�FL� i'��o�✓r'.i's <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> i <br /> Descrip�ion of Work l0 8e Done�. ' '� � ��y ' ������ `- -' ��� ' :1'f S r�/) ��PCA� .`-)iSY'in�'� <br /> 1 � <br /> �� i <br /> �P�-ull5 ��i) i > / 'VEw R6�FV fr�c � An/D (�%�nitd �iN:� � POtE. 5u�i%c,yE>". <br /> 0 <br /> ����Q E/TCNEn! �f"t�ATN,PDn� '�F�i�r�s �-[%!� y � t�t r/' .:l� v,�iE '^l�' /�;SP./�1' <br /> � �lC�N,TiN(, . MiC��tv,4�,�E� /7N�, 9JEiL-�. <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. ��' <br /> � <br /> ,h %; - <br /> , <br /> �� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certAy fha(I hai�e read and examined this application and kno�v the sante to be hue anA <br /> conect All provisrons o/laws and ordinances guveming this tyUe o/�vork�vdl be completed <br /> �vhc(her enecdietl herein or noL The gran6ng oI a permrt does nof presume fo give authonty�to <br /> violate or cancel lhe provisions o`any ofher state or locsl la�v regulating consfn/cfion or fhe <br /> pedorrnance cl constniclion. Thal l am aulhorized by fhe owner o/fhis property fo pedorm f6e <br /> �vork/or�vhich application is made and I comply�vith !he State Contractors La�v 7H27 RCW and <br /> 296.200 WAC <br /> , , � � �7 <br /> � 1 •� _,� . ' , ���> � _ <br /> �i�iyy{��' �rL'�'L%l..Y -- . . ._ � i ; '� - <br /> Signalure Date �(J` . <br /> i <br />