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ELECTRICAL PERIVRIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES s��o <br /> 3200 CEDAR STREET, EVERETT, WA 98201 g� /� <br /> 425-257-8610 - FAX 425-257-8857-www.everettwa.org ���p 8'G�b <br /> APPLICATIONS ARE ACCEPTED fROM 8 AM TO 4 PM <br /> Z 5 J L (�(.�el i^te�� �!/c: , <br /> PROJECT ADDRESS <br /> r j�c� �e,�ap_v� <br /> Owner G Mall Address City Stale/Zip Phone <br /> / <br /> ��i .5/ `�//tc �14y �i 5 <br /> ( d <br /> Tenanl Mail Address City State2ip Phono <br /> /-',xcr��)f�cn4� Ele�fi«� �yo3c ls.,('o.� FL,SE _A�Z� �,.r.�E �q y�z�z 'fL3=.7/% �`153 <br /> ElCdricalConlraCtor A7ailAddress City Slate/Zip Phone <br /> ov . <br /> �Xr'F.:P�� 9 �3�6 �00(���— <br /> State License Number Contracl Price of Work <br /> L�.�.µe�c.i4.� Y/y� . <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work l0 8e Done: l`��V �� � 'f'P✓[.n ��U��� Qn�« Qec.r��T��'�f. <br /> i <br /> ,Qe'h'� -,G�� .Fr.c� Lor4,-.�1 /�✓o/ ��c..i 1 S <br /> NOTE: WIRING IN NON-DW[LLINGS IS RCQUIR[D TO F[E <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 /. /� <br /> 1 hereby ceAily t1�3f I hnve reod enAexamined fhis application and know fhe same fo bo We and � ��L��� ` V.S� <br /> correct. All provisions ol laws and ordinances goveming fhis type oI work will be completed <br /> � �rhefher spea�icd herain or noL The granfing o/a pennd t'oes nof presume to give a�fhonty(o <br /> violale or cancel fhe r�rovisions o/any other sfale or lecal law r�egulating construchon or fhe <br /> pe�fomiance oI consiiuction. That 1 am acfhoriz�d by the owner o/lhis pr'operty fo perfomi the <br /> work lor wWWWhpppich applicafion is made and 1 cornpfy�ro�ifh fhe Sfate Confracfors Law f827 RCW and <br /> 29G.20Q� C. <br /> / /� ^ � �— ��/L <br /> � �„� _�.c O�� <br /> , ij����--�� �� - L�--Cc— <br /> Signature Date <br />