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/,-_� <br /> i <br /> ELECTRICAL PERMIT APPLICA�'ION <br /> CITY' OF EVERETT PERMIT SERVICES <br /> c�200 CEDAR STREET, EVERETf, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPI_ICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> .��9 r_rv�2G�r�_,J �,�i;Y <br /> PROJFiCT ADDRESS <br /> Ow�ier lda9�ddress Ciry Slate2lp Phone <br /> �FC �E�� �Ss�i✓� �s s��r�-r.� r✓�.��s��3 y <br /> Tenanl Mail AdCress Cily Slale/Zip Phone <br /> C`S li.IX�'CT�'iC�9L J <br /> su,�p�r fis��✓r<,�s ;i3yir��si<y��i2 �1�3 �ir��ir�J . (,✓t�l�'���8 �66/s�s' ,���b' <br /> ElectricalConiractor MailAddress City State/Zip Phone <br /> �-�r�_fi���,��s�� _ ��.��,Y�.�� <br /> State Licen=�i�umber Conlrac Price of Work <br /> Cr�2�5 �2r18c��� l <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Description of Work lo Be Dono: �.��(?/�%//���i F/a 1 L�('r% ��J�.j�(� lHfi �.�`Ki/��''' %�� <br /> Fta h?/�/A'.✓i Cf�1ti�S /� ) �� ST9,Jl)�/r� �ti����.J Fc;vns �/��)L�1�5 . <br /> ���;�-r �;� c��-�Ps �.r l,i�,> sh N�s�,es. <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO F[E <br /> Bc IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I heroby certily fhaf I have read and examined Ihis applica(ion and know lhe same(o be fruo and r I�xY) _(�S� <br /> correcL All provlsions o(laws and ordinances govoming this typa o(work will bo complefed l.� W v <br /> whefher spec�fied herein or noL The gran(in�o/a perm�f does nel �rasumo fo give aufhonty fo <br /> violafe or cancel fhe provisions of any other state or local la�ti-ragul tinc�consfrucfwn or fhe <br /> perlomiance o(construcNon. That 1 am authorizeA by the owner o� fhls property fo perfonn fhe <br /> work(or which appllcation is rn id 1 mply with fho S(ate Confractors L w 18.27 RCW and <br /> 296.200 C. <br /> � � lo <br /> Signalure Date <br />