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!'�l�l� ��,�,,;}— L�c <br /> � �-.[�.�2_�S <br /> f3 - 17_��t - o�� <br /> ELECTRICAL PERN�IT A <br /> PPLICATION �'� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 96201 ��Z �� Z <br /> 425-257-8810 - FAX 425-'157-8857 —www.everettwa.org fQ <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM L7�lZ I v'��� <br /> 43►0 ('�� ��,y ��c—����� Su,TE 20� <br /> PROJECT ADDRESS <br /> Ownef MailAdCress City StatelZip Phone <br /> �s, � ac�� n' �n Q 3��. G I l� �luen�.�e C-�+F�tj- t�I* `�4 ZC.'� 3 <br /> TenaniM� ��q� ��r..`O MailAdtlresa City StatelLD 7��hone <br /> '�ri�i���l C�ec�r�c LLL IS4-k� �►IS-��,p5� S�t��L�o�nish 1.�}h `1&7�1� lcb�;'Soch: <br /> Eleclncal ntractor Mai�Address City Slalel2ip Phone <br /> �ititc � �T11rL3 � � � �1c� . `� - <br /> State License Number Contract Pnce of Work <br /> 3 ��,� c�-�F«"13�,I b,:, — <br /> Proposed Use Bui�ding L'ontact Person (Plan Review) <br /> r� (. � <br /> Descriplion of Work to Be Done: ��M ct'il oM1 S � Y�<<C��� �p�'K � L'�a�� yj 9 cL��� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CA6LE. �O ZO <br /> O -� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 1105 <br /> I hcre6y certify thaf 1 have read and cxemined this application and know fhe same to be Irue and �', � �� <br /> rorrecf. All provisrons ollaws and ordinanr.es govenung this type c�work Hi�l t�e rompleted � O �- Q <br /> whefher specilied herein or noL The g�anlinq of a per,nd does nof p2sume fo yn-c aulhonty to <br /> viulate or cancel the provisions of any other slate or local law regulafing construction or the <br /> perlormanco o/conslruction. That I am a��honzed by fhe owner o�fhis property to pedorm the <br /> �a�ork lo��vhich application is made and 1 cmnply wdh the State Contraclors Law 1817 RCW and <br /> 29620G WAC. <br /> �' 4 � ,�_ , o � � Z� i2 <br /> ---�-�re Date <br /> � .,y,.o� <br /> I <br /> ' -- --- -- <br />