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< < <br /> ELECTRIC,AL PERMIT APPLICATIOIN <br /> CITY OF EVERETT PERMIT SERVICES �� �Z;y�O7 <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � o7/O`/I� <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org <br /> APPLICP.TIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> C � 1 '� �'i41 �S ��L��� iz�'�z 2%z.�� u���� ��'��' � <br /> PROJECTADDRESS <br /> � � � � 1 Z rJ Z') Gi?Gz.S p'1l,�rt �<vzr�',� �j GL�Af l�Z G'l <br /> t�%���c J�Ji• ' t- <br /> Ovmef MailAdd���;a City State/Zip Phone <br /> �3:� rr=5c�� . n+aSl-ISI-I�li z'7�� f'Zc1 <br /> t 'r.Y� !'IL![ /l_l)�L2�L ] / 6L��4 <br /> Tenant Mail Addiess City State2ip Phone <br /> ,r�2�[�,�,'e� �n1t �crir�l'k"ll�WlT�� r'cva vaLc oNr4 lti'A� 9�c�ol ��• .595�-o3/f <br /> EleciriC3lConiractor MailAadiuss City State2�p Phone <br /> nn <br /> �i��"e o7_���i9/�t�l _ Z� r�'7'>. <br /> State License Number Contract Pnce of Work <br /> /Jr; � cie _ � �ii15 C/1C' .!L c'� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: /G- C� f �i2�2 �'I L r1P 1v1 �LT �i��it'/��1 <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT IOCAL SALES TAX CODE IS J705 <br /> 1 hereby cartily fhat 1 hava read and ezamir.�,.,�his application and knav fhc same to be true and <br /> correcL All provisions o/laws and ordinanr��>.io��ommg fhis type o/work�vili�?complefed <br /> �vhefher speci6ed herein or not The granfm,r �I a pemid doos not presume fo g��e authonty fo <br /> violate or cancel the provisions ol any ofhe� r:re or locallaw regulaling consfrucl.on or fhe <br /> poriormanco o/consf�ucfion. Thaf I am autn �.zed by fhe ownei ol this property fo neAorm Ihe <br /> wo�k for which application is made and 1 co�r,:� �wifh fhe Stafe Contracrors Law 18.?7 RCW and <br /> 296.200 WAC. , <br /> i / // <br /> �/ l_� � ;�/�/�� ,G/" �L•i— C�J,_ �J ,� <br /> � <br /> SignaWre � . ���e <br />