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=t � <br /> ELECTRICAL PERMIT APpLICATION <br /> CITY OF EVERETT PERMIT SERViCES <br /> 3200 CEDAR STREET, EVERETT, WA 98�01 S—/ U�-U�' <br /> 425-257-8810 - r=AX 425-257-8857 -v�riv.everetlwa.org S.� � <br /> c,�0�'o <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 2�� ��v��f�tiU� ��' , ��l � <br /> PROJECT ADORESS � <br /> I <br /> � <br /> ��� �,�-� �,i h�l �j �%�j�_ f,t���i � <br /> OWnef I.failAddress C�ty S�atc2y Phene <br /> VINt i�(1-() �315 ���� Q� �Sr •�I�la�`"�S�Il,i.l-" W�c �Gy2�-D S°o?�� <br /> TCnanl h1ail Address Cily SlatelZip Fhenr <br /> CN f�P—�.�.� qf�No�J I ( l Z� 31� � 5� C������1 9�� 20 I _ <br /> Eleclrical Contrador Mail AdOress Cily 5:����'=, �"i0^" <br /> � � ' � <br /> C ) � � � � �, t��sii•��t �-�� �\I j�',N _��,�4i.� � <br /> � � � � (� �f.f� v - � 'v�' <br /> �l�l�� � � 19�'�i���; � !Z ( �� �� ( ��C,�.� - l�N - <br /> Slalo License Number � Cdnir,ict Pu,.e of 4Vork <br /> �i����t�,.� �����i���i rt l��������ti� <br /> Proposed Use of Bui ding Contact Pcrson 1�'lan Rcvie�.�� <br /> DescriptionolN'oiktoBeDone: ��U`�'I ��l'��' J�'��C�� � <br /> tJOTE: NIRING IN NON-DW[LLINGS IS R[QUIRE� TO FEE <br /> 6F ItJ RAC[WAl'S, MC OR AC CA6LE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily thal 1 ha��e read anAex�mined this applicafiaa and know the sarne fe be true and <br /> corzecL All previslons al la�vs and ordmances c�overnin�lhis fype o!n�odc will be completed <br /> whefhe�spea6ed herein or noL 7hr, g�anling o(a pennd does not �resurne to gire authorit}�to <br /> violate or cancel fhe provisions ol an��ofher state or local law regulatin�consVuc6on or Ihe I <br /> peilorrnance o/consfrucfion. Thaf I am aufhorized b}�fhe ewner ol Ihis property to perfomi(he <br /> �voih lor'which application is made and I cornpry with fi�� Sfafe Confrnctors Law 1 B.D RCW and I <br /> 296.Z00 WAC. �. <br /> i <br /> ^ �' i <br /> ,��/U-�' � � �� ��� c ,p� <br /> Siqitalurr Dale ��1�d�-U�J <br /> �!(,• C�C� Cr�UM�t"(�Iti`�- <br />