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ELECTRIC�L PERMIT APPLICATI�N <br /> CITY OF EVERETT PERIVIIT SERVICES <br /> 3200 CEDAR STREET, EVERETf, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ���-� � �y S7- <br /> PROJECT ADDRESS j� <br /> ���X Cof��fiys � �/l �T� sT �v�i�� ��v4 g��� — <br /> Owner Mail Address City Slate2lp Phone <br /> Tenanl Mail Address City S�ale/Zip Phone <br /> �(�i��� G�/>�ri, c ln� /3��o�T�>�✓����d�����7����/i�/� (.d/a 9�'��z l/����/ <br /> Electrical CoMractor Mail Address Cil� Stale2ip Phon� <br /> ���C/�L-T 95� 2 �� � ��� <br /> Slale License Number Contracl Price o(WorY. <br /> �/-C J'`s//7�/i ��I� / i/I���l _ <br /> Proposed se of Building Coniacl Person (Plan Review) <br /> � f // I / n <br /> Description oi Work l0 6e Dune: �f�{�J y/g!/ ���w �Y�N�r9�r� `� �//'/�J �//l�Gji�`t 9l��,/ <br /> I h.,1f9�� � {��GL �9�L!/ooil� �� L^ '�Li�y/`f {"YIOI/r 3 `i�-hT Sw�iti� <br /> 9�'/r/ �-� 0%i�Y � -�.i', Sl i� PXqHrT /����5 <br /> , <br /> NOT[: WIRIIJG IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 (� GjCr�� � u`�`L <br /> I hereby ceMi/y fhat I have�ead nnd examined(his app/icafion and kno�v Ihe sarne to be frue and � <br /> correct. All prowsions o(lau�s and ordinances go��ernmg Ous type ol�vork �ti�ill be cornpleted <br /> whe(her speafied herein or noL The c��anfing ol a perrni;does no(presumo to give aufhonty fo <br /> violafe or cancel(he provisions oI any olher sfate or loca/law rec�ulolino wnsVuction or the <br /> performance o/censtruction. Thaf I am authorized b}�the oirner oi lh�s property lo pe�fonn(he <br /> work!or which applir�fion is rnade and 1 compty rvifh fhe Sfate Confracfors La�v 18.27 RCl1�and <br /> 296.200 bVAC. <br /> ��' �j' //�i j <br /> �;�����f�l����---- ;_ <br /> -- STynatwe Date — <br /> — --- i <br />