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I <br /> � � � rc��[i'��r�;� - <br /> ��: �, _ _ , �� <br /> � �av o 4 zoos --- ELECTRICAL PERMIT A�PLiCATION <br /> CITY OF EVERET?' PERMIT SERVICES Q-O�--� 6 <br /> 3200 CEDAR STREET, EVERETT, WA 98201 L 01O S—o3 3 <br /> C I�i ' o F F V t=R t_1 T 425-257-8810 - FRX 425-257-8857-www.everettwa.org <br /> L-,.., ,�.e��I�t1IFat�!:� S�::vii�.C:; <br /> APPLICATIONS ARE ACCE;TED FROM 6 AM TO 4 PM -DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> ��,j o i� � t v;ijtr C l�F�r-� �^�Ii'`i <br /> PRCJCCTADDRESS <br /> �— � �� EvF-iYi9T a.i{} `j�; � ( Z <br /> � � � vr-,.� l�[, � p,� . a�h 3'b� <br /> Owni.r . MuilAddress Ciry State2ip Phone <br /> r��Lai.i�Sl:u�`� C�LL-7S.LaN S✓<iv �: �F,LGI�F�L,� CVfnVFiTT t,�/� `/ �2L3 `fJ.J -?Si 3� �I <br /> Tenant MailAOdiess -�RY Ciry State2ip Phone <br /> S I f.. riF-�Sv.�l S��6 i� 1 7�3 Y- lr�.�a��t,a ir�,f . N. SI-N l7ti LT�"t- �-� `/��I S s ;1 a� - S'4`1 -k �37 <br /> Eleclical Contractor Mail Address Ciy Slato2ip Phone <br /> 'SPI-� I�F S119� � I �✓ � � G G' . J � <br /> � State License Number � Contracl Price of�Nork <br /> ! Cai� !-1F�"L �yf? l, TI� ��SS L�iMJr�LtW�i> <br /> Prop�sed Use of Building Contact Person (Plan Review) <br /> i Descriplion of Work to Be Done: C cn� M= �7� I) <br /> w�/✓yr✓ G L y �i N�-1� ��� r kSS' I�]vb <br /> �Gl 7L(, �-i - � I?iL , C 1-1-� %o- L ,� C f�'7�-���/ 6 ( �'�-f�.1L ) <br /> NOl E: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CO�E IS 3105 <br /> 1 hen iby cerlily fhat I have read and examined this app!ication and know the same fo be We snd <br /> corrc ct. All provisions oflaw.s and ordinances goveminq this type of work will be.complefed <br /> whel ier specified herein or nol. The granfmg of a permit dces not presume to groe authonty to <br /> viola e or cancel fhe provisions o/any ofher sta(o or local law regulating conslruction or fhe <br /> poAc rmance o(conslrucfion. That 1 em cuthonzed by fhs owner o(fhisp r�perty to pedorm the <br /> work/or which applicafion is made snd I comply with the Stafe Contradcrs Law 18.27.4CW and � <br /> 296.;!OO WAC. � � <br /> �- J <br /> � � l�-��1� �� �� 'f�� � r <br /> SignaWre Date �!; � <br /> �� <br /> I <br />