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ELECTRICAL PEI�MIT APPLICATION <br /> CITY OF EVERLTT PERMIT SES�VICES � �_og <br /> 32W CEDAR STREET, EVERETT, WA 98201 3 " <br /> 425-257-8810 - FAX 425-257-8857-ww�v.everettwa.org ��go3_d�l <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �(�OC� /'i�-�.CC Y.'� C��. <br /> PRQJECT ADDRESS <br /> �/r"`/ 0�1 CVE2� �✓��lT- J�(�l� J`�ZO/ <br /> OWflef Mail Address City SWIe/TJp Phone <br /> ( 'r�-Hf���T /fie�Jl/� ��� ��" l��Dl 322�iZG�e, <br /> Tenanl Mail Address City Stale/7Jp PAme <br /> /,/ � <br /> J��L�L � _t�ZT��C J���I����OUAA�L��lN/I' P8�t1/ Zs2-/k1O <br /> Eleclrical ConVactor Mail Address City SUle21p Phone <br /> n�i I�s v�- /ol }��C � 30�'0 . oa <br /> te Ucense Number Conhact Price of ork <br /> �_✓,,C��� ��,� �c/ .� <br /> Pro o ed Use of�ullding Conlact Person (Plan Review) <br /> Description of Work to Be Done: !��'���- ,!� !C-�G�J � �' ���-�� ��T�f'C:��" <br /> �- . , <br /> ����f�iLit_. �-r_�or_�u V_G-c�_ .—/f�'.CL�' � ��✓_-Z«r� ui'6-«`-[; '�/ . <br /> �--�- <br /> I 1JOTE: WIRi�!r IN NON-DWELLINGS IS REQUIRED TO FE <br /> BE IN Rh^.EWAYS, MC OR AC CABLE. � � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 sp <br /> 1 hereby certily thaf 1 have read and examined fhis application end know fhe seme fo be true and 1�� '� <br /> cortect. All pruvisions ollaws and ordinances goveming this type oI wodc wili be complefed <br /> whether specified h�erein or nof. The granting ol a permit does nof presume;o glve authority to <br /> vlolafe or cancel the provisions o(any othor stafe or local la�r re�ulating conshucUon or the <br /> peAormance M conslniction. Tpat I am authonzed 6y fhe owner of fhls properfy to peAortn the <br /> work lor which application is matle and comply wifh fhe State Contrec(ors Lew 18.27 RCW end <br /> 296.200 WA�. <br /> � �:. �' <br /> � :�.F%,;".�/ �C l't/, � !�L.GC �// 7/O <br /> SignnNre-- Date <br /> ��03-a8� <br />