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( - <br /> ELECTRICAL PERMIT APPLICA710N <br /> CITY OF EVERETT PERMIT SERVICES g����y <br /> 3200 CEDAR STREET, EVERETT, WA98201 �,�IDQ�l6y <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ` ��UO T�W 1� S'� <br /> PROJECT ADDRESS <br /> ��i=�,--fj cL �w�l ��e�-sT 1=vi=�'i�iTVVA <br /> Owner Mail Address City Slate/ZIp Phone <br /> 5�M � phone <br /> Tenanl Mail Address City StateZp <br /> µTt� Ern;urc �tic `1�z 5 �iot� s�kT?.� A�� 9�68 yz� �� o, � <br /> ElectricalContraclor MallAddress City Stale2lp Phone <br /> 1��' - K-"r1� °�}'�0 I 0�2(o�Z- �U oOJ <br /> Sla e Ucense Number Contrec Pnca ot Work <br /> Kp(j'LC-1 �I�.S �-3Cou� � <br /> Proposed Use of Building Contact Person (Pian Revfew) <br /> Description ot Work to Bo Dono: <br /> T�X �1� M�C T Q- 'PuL�'OS E (-�J M Y�I�E <br /> w i L PT� � Sw i�cH �-�i � t=1n� A�a��-M � 1��or�i� 1�/+T-/-1 �N <br /> ��,�� ��T�r��� ���s ��= ��� �= cLo r�r-r-,=,� w� � �+ <br /> r1 �J✓ 1+��i Fi'��'LS aN�J CAi� L<<nitl S- �.uST4[.�. �5 C�f���e <br /> 5�C:l� C,I�I C�f'S' FEE <br /> NGTE: VVIRING IN NOIV-DWELLINGS IS REQUIRED TO <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES 1AX CODE IS 3105 <br /> 1 hereby certify fhat I have read and examined this applicstion and know fhe seme to be true and ����� _� �� <br /> correcL All provisfons ollaws and ordinances goveming this type o(work will be completed <br /> whether specified herein or noL The granting o(a pormd does nof presumo to give acthonfy fo <br /> violafe or cancel fho provisions ol any ofher stafe or locaf law regulating consWcCc:or fhe <br /> performance ol consPruction. That 1 am aufhonzed 6y fhe owner oI this property to pedomt the <br /> work lor which applic ' is made and I comply with the Stafe Confractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � �2� - 1 <br /> Signature Date <br />