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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR ST REET, EVERETT,WA 98201 <br /> 425-�57-8810 - FAX 425•257-8857–www.everettwa.org <br /> APPLICATIONS ARE ACCEP7ED FROM B AM TO 4 PM <br /> L LE U1 R.l,l C,f�.PiY P�V.Qi i �Vf GI�7—Q I <br /> PROJECT ADDRESS <br /> �,G�,n r �1cMc_t�' �2 '��� nr ►.��,, �iv+- ��/���� �[z5.��f�zoz <br /> avfler MailAddress C�ry Slale2ip Phane <br /> TC119nt M8�1 Addrena Cily State2�p Phane <br /> �y�nliy;�(pc��� Ic���7r���ar�r,w l.�k-cv� s��. v����ro `Pi� ,�i'�.�3�t <br /> Eiectricei Concractor M,u aaaress Gn s�,cerz�p Pno�e <br /> ��,WIN �I �llpalCi7 �2-300.OQ <br /> Slatr License Num6er Coniract Price of Work <br /> 12 Psii-,f�P!/1�t'1'NL �I l lVi '��f/=�✓•�,.�0•�1G{GiZ <br /> Nroposed use ot�3widmg Conta erson (Plan Review) <br /> Desviption of Work t0�e DonB: �Q���C.Q. �a�DL n� �Y l�C� �/�C� � J1���� �/�1R- <br /> 2� �1rn�� LI l�P,( t��r -�=f�i'—C'�,���t,7� • <br /> � � i;�G <�, <br /> NOTE: WIRING IN NON-OWELLINGS IS REQUIREO 70 FEE <br /> OE IN RACEWAYS, MC OR AC CABLE. p�' <br /> �j5_ <br /> CITY OF EVEREIT I.00AL SAL[S TAX CODE IS 3105 <br /> I hereby ceRily fha(I havo read and exsmined lhls appdcatiori and knowlhe same to be true and <br /> cVrrect All pmvislons o11ew5 nnd o�tlinances goveming Ihis type o`�vork will A9,Gbmp�eted <br /> whether specined hemin ornot. The�ranting ot a permd does nel f,resume tu grve authonry ro <br /> v�olate or cancal the pmvrsions ol sny other sfate or local!aw regu amp constnidron or fhe <br /> perfonuanco oloronst�ucfron. Thsf I am authOnied by the ownorolt4i5 ptipert}'to perfOMt f17B <br /> �+vrk Por which applrca(�en is mado and!comply w�m�he State Contrac(ors Law 18,27 RC W and <br /> 296.200 WAC. <br /> i�yG'�G< < �ti'%`�'/l�r., �s�� !o�lS-� <br /> � SiOnelum � DntO <br /> �L7C'V — �i,� � <br /> L�l/Z,[� 39Vd 'JI�1'�3�3 N1M��3 hLSTZ9809E £h�6� C00L/Si/9C� <br />