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i <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 7 -' a� ` �g <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org �p'QO�� 'a2 <br /> APPLICATIOkS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> /OS2o � 9�h A�,L� S,�L. rz��z��T, W�- 9820$ <br /> PROJECT ADDRESS <br /> Smµ4S� LLG z8r� co�8 f I1vF Fvne�-�' w� 9B2o� <br /> Owner Mail Address City State2ip Phone <br /> Goasrp� Ca✓r1Mu.�f�?S/ f3ANk i�sza i9fh au� se rzv��a�rr ,,,�a 98�5 <br /> Tenant Mail Address City Slate2ip Phone <br /> �Q�iQ�tl� �AIL /O'J NJRSI+i,I�-�a.J BWD. Y��.L.e.t1EF ulA. qocol 2GG•5`�5"�3/l <br /> Eledrical Contractor Mail Address City SlatelZip Phone <br /> h�aro% �o99�� 3,3Oo. °a <br /> State License Number Co�t Price of Work <br /> t�Anllz / ac��pauc�c t3 17Au�L �cw�n9a12. <br /> Proposed Use of Building Contact Person (Plan P.eview) <br /> Description of Wcrk to Be Done: /-1 i2fz r4L142fY1 �in)A�Jr I✓N pj2AUFtYN2A9 i, <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR�aC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � <br /> I- C�� - � ZZ <br /> 1 herr,by certify(hat I have read and examined fhis applic�tion and know fhe same!o be frue and � <br /> conecL All provisions ollaws and ordinances govenung this type ol�vork will'oe completed <br /> whether specilied herein or noL The granfing ol a porrnd does not presume fo give aufhority fo <br /> vio.afe or cancel fhe p�ovisions olany other s(ate or local/aw regulating construcbon or fhe <br /> pe�fonnance o/cunsf�ucfion. That I arn aufhonzed by(he owner o/this property to pedorri fhe <br /> woik Ior�vhrch applicafion is made and I compty with Ihe Sfafe Conhactors Law 18.27 RCW and <br /> 296.200 V✓AC. <br /> � - �� 7_Z2-°� - <br /> SignaNrc Date <br />