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- e � <br /> �LECTRICAL PERIVIIT APPLICATI�N <br /> CITY Or EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, UVA 98201 <br /> �i25-257-8810 - FAX 425-257-8857—wvuw.everettwa.crg 1 � "� � v�3 <br /> C- �s��-�a5 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 5�3� ��f+��- �/ <br /> PROJECT ADDRESS <br /> I lP�U1�J I^A�Y�1 i UD t7,� )�LD L�4f��IGI 2 (Zs6�' /y� /1 �PI�G��Q�� �hane <br /> Ownef M11aA Address City SIat�ILp <br /> CWL'� �I�CS 1.1,4 �MIhIIIM ��[`a P <br /> 7enan[ Mai�Address Ciry StateZp Phona <br /> __�����..�c• 203� Qicnor� � s �E �11�A �13y Zl/,h•.32''6�3Z�f� <br /> Elecinca!ConU2 ,.f Mail Address Iry State2ip Phone <br /> `�IASFt"�l?��.�3 - - ��'�"`.�°' <br /> State license Number Contred Price of Work <br /> �� ���WLir� <br /> Proposed Use of Bwlding Conlacl Person (Plan Review) <br /> � / I <br /> Oescnption of Work to Be Done: �,��niF� �tL�' rt�n'SS�1�� �V�� �^��� <br /> NOTE: WIRWG IN NON-DWELLINGS IS REQUIRED TO �E <br /> BE IN RACEWAYS, MC OR AC CABLE. �j.� <br /> CITY OF EVERETT LOCAL SALES TAX COUE IS 3105 <br /> I hervby certity Iha(I havo read and oxamined fhis applica(ion and know ll�e samo to 6o fruo and � �� � � , � 1/,� <br /> correcL All provisions of L�ws and ordinanr.os 9ovr.rmng lhis type a/wo�k will be complefed % <br /> wholher 5pecilied heroin or noL Tho grdnfiny of a poimd docs nof resumo lo givo aufhonty(o <br /> ✓iolato or cancel fho prov�srons ol any olhe�stafo or local lavi rc yuPting consbucGon or(he <br /> pedormance o/consfruchon. Thaf 1 am authonzod Gy(he o�vnnr o/this propeity fo perfomi fhu <br /> wnrk loi which appli�afion is mado and I comply�vilh fho Sfale Conln,r.fors Law '827 RCVV and <br /> 296200 WAC. <br /> � � n�v�n_._ (i�n.0!(J �(/1� 7 ( � � <br /> '�gn fc Dalc <br />