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OJ-11i201J 16:55 FAS J:SJ5989�J E�•ersreen Securit�� fm002 <br /> i <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES 3_,�a-t3 <br /> 3200 CEDAR STREET, EVERETT, WA 98201 c �� �-3 .p7 <br /> 425-257-8810 - FAX 425-257-8857-www•everettwa.org C <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � �f Z� �DQ��.�� <br /> PROJECT ADDRESS <br /> / � � lJc�i � i i�;`��.� .�,nr ��I� �GF'l.Q �'� I'�'� �'���"� ��'o� � <br /> �`^' � Phone <br /> Owner Ma�i naamss C�ry Scatertip <br /> (� �. l.-h7u.�2 I�al �dsVDG��a Lv�.wQk �-�i�'� Ll'T�-3S7-(o?7fo <br /> Tennnt MailAddres6 Gty Stale2�p Phane <br /> '�"' l,�"a�3`� '{� <br /> �"��,�-�„no�n SeCu�.���l ��-&�.� lol G-v� <br /> Electriral C iUaGor Mail Ado�yss Clry D�— State2lp �'�^e <br /> �.�IG►Z�s�i �a�a � 5��. � <br /> State License Number Contrad Price o(Work <br /> ,D�6�QX �(`L1� <br /> Proposed Use of Building Comaa Pereon (Pla_n ReviQw �G <br /> ��r!<- <br /> Description of Work to Be Done: �M�y` `–�� � ���`�� � – <br /> 1 b�.��,�L� -� c�.�v�,� C <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIREDTO FEE <br /> BE IN RACEWAYS, MC ORAC CAeLE. �� <br /> CITY OF EVERETT LOCAL SAL[S TAX CODE IS 71U5 <br /> � I horoDy corGry that 1 have reed end ezaminoC tn;s aAW��tion and know tho same(o be true end �3 , � 7 <br /> � cor�ect. All pmws�ons of laws and ordinances,qovommQ fhis fype ol work wiU bo complefed �� O� C.-- <br /> whofher speci(,ed herein or noL Tho grantiny of a permd tloes not prosun�e to yive outhodty fo <br /> violafe or cancal fho provisions of any otherstafe a local faw iegufnting cone7rucGon or Ne <br /> performance o/conSiruCtiOn. 7hef I am authonzed by Ne ow0e�of this property to poAoml Lhe <br /> woB/ot which application is matle antl I comply wdh fhe Stefe Confrectors Law 18.27 RCW and <br /> 296200 WA� <br /> 3 ll l3 <br /> Sgnature oata <br /> o�� — <br />