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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 G � �3 _p � <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org �0 g06 '�73 <br /> APPLICATIONS ARE ACCEPTED FF.OM B AM TO 4 PM <br /> �� %��� i��ILICG it �dG ���//�.C�t/ ���XJ2 �7�'1 � <br /> PROJECT ADDRESS <br /> yZS'Gos= 3SY,� <br /> JG—;�lS Jo�,,..�so:_ 3You ib,s"i�' S/ .S(.t� (�,n/.aJ�.✓rl��� 7�- G 3 -� <br /> Owner L1aii�ddress Cily StaleiZip Phone <br /> �Un/L �c -fGrs X <br /> TCf18nl R7ail Address Ci�y Slate/Zip Phone <br /> yl-S� 30.�-063� <br /> �'G2 C L GGl a S Z Z /2CiC6as2.�ur S'rA�fc .�7 Z Ev�s2v�{/,t/.�J`���i� <br /> [lecirical Conlraclor Mail Address City lale2ip Phone <br /> E=f2Cr-� +kll- S�b' c � 3S�d `� <br /> Slale License Nmnber Conlracl Pnce of Wor4: <br /> (�G,�L]C"1 z S c.r /���— <br /> Proposed Use of Duildin� Contacl Person (Plan Revie�v) <br /> Descriplion ol Work lo Oe Dune: I Z�LU t-�i..e= ��j9 r � c�c.c.VL�w'f- �v C � � <br /> ade a y ��w.��C,. �� . ��� wo2c� � �� �;�� <br /> ' NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE W RACEWAl'S, MC OR AC CABLE. <br /> J <br /> � CITY OF EVERETT LOCAL SALES TAX COD[IS 3105 <br /> 4� I herebvi certily fhaf I har�u read�nd examined Ihis applicatiun t�nd kne�r the same to Ue frue[�nd <br /> con�ei-f: All pro�isions ollaws and ordinances yorcmin�fhis type o(n�ork �rilf be complefed <br /> �vhether specJi��Aherein or noL The gianlin�ol a penrut do�s nof/nesume fo give authonfy to <br /> violafe oi cancol the I�rovisions of an}�ofher sfale or local law regulafing consWcfion or fhe <br /> perfonnmice olconslnicfion. Thaf 1 arn eufhoiimAb}�the o�rner oI tlus property fo perfonn 7he <br /> �rork 7or�rhich applicafion is nr.�de and 1 cornply�sifh the Stafe Confractors Law 1827 RCW and <br /> 29G,200 lM1'AC. <br /> , , � <br /> _ _- I��C� `-- t�'(�-�� .7�t-+-c-c l4 Zc�y�- � � �;; � I-� <br /> Si�in,nwe ---- Date . . <br />