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ELECTRlCAL PE�MIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org �� ��_� $ <br /> APPLICAFIONS laRE ACCEPTED FROM 8 AM 70 4 PM CTO'gD� �D(� <br /> ������� � /c �� ��� �-� ' � <br /> PROJECT ADDRE�S <br /> � r <br /> � /�� o��/,"'-� l ( /:c`_��)t F_; 11 f (L. � ;��"� / Cc L,�%� i}1<� ��,���4.� �-52 Sy�.� <br /> Owner ldail Address City Stale!Zip Phone <br /> L � ; � .�-7<' 's\ ; ,, ( �:�.� ��- _ � r�"il! �e� St CVcl2-��j"T � �- .•} <br /> Tenanl Mail Addrese City Stale/Zip Phone <br /> ; <br /> `r�% ' '3�'.F/E � <br /> ��; � : 4 ( .�lt, v (�� ��Ufc� � 5� i(..?i.� � ;', �lidc �-��.��t�� /1�,� �/�%: 3�) /ivi< <. .'ce)� �e.J <br /> EleCfriCal Con�raclor Mail Address City Stale/Zip Phone <br /> i <br /> /:�i % Sl� � ���. j�� � ��� �� <br /> State License Nmnber Contract Price of WorY, <br /> 1 �_ <br /> [�� � <br /> � � 'T\l L_ �7G l i'vl� ��'�'�' �/ G � <br /> Proposed Use oi Building Conlact Person (Plan Review) <br /> Descnplion ot Work lo[ie Don�: _ �� � l �i �� < �- � r � , }� ( `. r (.,,(: <br /> N07E: WIRING IN NON•DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br />� <br /> i <br /> i <br /> CITY OF GVEFETT LOCAL SALES TAX CO�E IS 3105 <br /> I hereby certify Ihat I h�ve read and exarnined fhis application and knmv fhe sarne to Ue frue and <br /> correcL All provisions ollaws and ordinances govemmg this type ol work will be compfeted <br /> whether specilied herein or noL The yranfing o/a pem:d dues not presume fo give aufhonty to <br /> violate nrcencel the rovisions ol any other sfate or local law regulating construcfwn orthe <br /> perform�ace o/cons�uction. That I am�iufhonzed by fhe owner ol fhis property fo perfonn fhe <br /> �vo�k lor��hich applic�tion is made and 1 comply�vifh(he Stafe Confiactors Law tt7.27 RCih�and <br /> 296.200 V✓AC. <br /> / ; <br /> � ,� ?%7 �/ � �� <br /> Si�n'ature� Da�e <br /> � <br /> .' ��� 'l.l�Ll <br /> i I <br />