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� • <br /> ELECTRICAL PERMIT ARPLICATION <br /> CITY OF EVERE7T PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> a25-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPUCATIONS ARE ACCEPTED FROM 6 AM 70 d PM ��4�a _i 47 <br /> , - :, �-=a�-+�( <br /> i �.:� <br /> �����- l�-cs� Dr � � <br /> PROJECT ADDRESS <br /> ,�,�S�av� g 5�0 oq ux s�. Dr �L� �v-u� 4 e�03 �3 �� <br /> Siatc2 p Pnonc <br /> Ownet MT��I ACdreu ���1' <br /> Gry StatelZiP Pho^�e <br /> TenBOt Mall 4Cdre55 <br /> �.R�j'1h2,4�fl-L A�l 'L� 1 , <br /> t � oo ► 5 �3�1� QL �a.�-It L��� C�I �F� <br /> CI 5131C2 D a O�F' d V � �hone <br /> Elecvical Contraclor Ma�i ACdress ry •"�a OC� <br /> '�,�( P ,r�,r��'�C�`�-l'�� ,�' 3 UO <br /> Contract Prfce ot Work <br /> State L�censc Number <br /> ��� �G��, ryLi-� <br /> Proposed Use af 9w�ding <br /> Contnct P¢rson (Ptan Review) <br /> Do>c��Ction of Work lo�e Oone: 1 1 \�`"`�l\ ���� � � �� u <br /> NOl E. WIRIIJG IN NON•DWELLINGS IS REQU�R[D TO FE[ <br /> [3E IN RACEWAYS, MC OR AC CABLE. G o O� <br /> J <br /> CITY OF EVERE7i LOCAL SALES TAX CODE IS�105 <br /> �nerrby cer7i/y that i have rend and examined this oGP��catron and know fhe�ame fo be froe and i: f I � O "1 ( ( � � <br /> corrett. All pmvis�ons of law5 antl ord�nances 9overnina fhis lype of wo�k wd!De completod [� I "[ �= � "r <br /> whefher specrAed herein or not. Tho g�antmg of s Oem�rt doos not resumo to glve auMonry fo <br /> vmlate o�cance7 the prov�s�ons or eny orner srara a�roca�law repuPfing tonstruchon or the <br /> perlormanre o7 construchon. 'fhaf 1 nm auNonietl by Me ownnr of(his properfy to pertotm fhe <br /> wo lor which aDPlication is made and 1 comply with fhe Sta�e Conbacrors law t8 27 RCW and <br /> J86 O W�C � <br /> � 2—_�o�,�— `�---- <br /> StgnaWre <br />