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0 <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES / <br />3200 CEDAR STREET, EVERETT, WA 98201 /O��$r �� <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org � <br />E Il/b -0 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�O 9 �g ,�ve��q ree�. �t%��,.� <br />PROJECT ADDRESS <br />Owner <br />Tenanl <br />ON �,.�„ I <br />Mail Address <br />�',rn S��'��aNr� <br />Mail Address <br />C I � .�-V . / -� <br />93z <br />� ,- - - <br />Eleclrical Conlraclor Mail Address <br />� � ��k �� 0.39/�� <br />State License Number <br />� L'�n. FiV'a� I � � < <� <br />Proposed Use of Buiiding <br />9�8 <br />,�veve� 9��3 <br />H �if/�cy ��P�e� Uli} ' <br />City Slale/Zip <br />�ec,Wa� Eve✓ei� �A <br />_ ��Y . <br />l..r- /i�l� 1 <br />Descri �tion of Wark to Be Dono: �"' ����� �� � h <br />� G��. .�,D tl K ec�' 7'� � <br />G� <br />e� <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that 1 havo read and examined fhis applic, <br />correct. All p;ovlsions of laws and ordinances goveming <br />whefher specifled herein or not. The granling of a permit <br />violateorcancelthe Provlsionso(anyotherstateorlocal <br />per(ormance o( c�nstrucfion. That I am authonzed by fhe <br />work Ior which appllcation is made and 1 compty with fhe <br />296.200 WAC. <br />. ..z _n �rr—� <br />aignacure. <br />��,,t e�,,,,-� c,�J f�.� �rn r S s�� <br />Slate/Zip <br />�(J66� <br />Gty � Slale/Zip <br />6a� <br />Contract Price of Work <br />yas-353- y5 <br />�g� <br />Phone <br />yas4 3�y <br />�— <br />��°'�ao. <br />�8a�� <br />Phone <br />Conlact Person (Plan Review) <br />i h s,�a 6 �. <br />r� <br />Y�ce. {'rD <br />and know the same fo 6e true and <br />ypa o(work wifl be comploted <br />not presume to glve aulhority to <br />egulating construcfion or the <br />er of thls prooerty to perfonn the <br />Contrac(orslaw 18.27 RC W an� <br />��� �f// <br />FEE <br />�-�ir o -a9� <br />