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i _ ' <br /> ELECTRI�AL PERMIT APP►�ICATION <br /> CITY OF EVERETT PERMIT SERVIC.ES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - Fi.X 425-257-8857—wv,vo.everetrroa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> >��'y �✓t�t�i��rn� ���t� <br /> PROJECT ADDRESS <br /> ��'✓��r,2 IrSwta�rc� S1i�N C��i'�,(✓wA� ��t�t�T q�Z�3 (�lz� �z3—�°IlI <br /> OWner Mail Address ity SlatelZip Phone <br /> Tenal�t Mail Address Cily SlatelZip Phone <br /> N�-(�di� S�c,J tv�1n IL5'f b✓t5��9'li /hC� i✓ S�¢ilt�lN9 9�1h9 �c6� 21'7 �I�O <br /> EleCtfical Contfaclof Mail Address City Stole2ip Phone <br /> /��l�l'3C��IiM3 .� ZS�.�C� <br /> State License Number Contract Price of Work <br /> ��i/� Z.���3Y711/�/ <br /> Proposed Use of Building Contact Person (Plan Review) <br /> DescriplionofWorktoBeDone: I�SI�L Ol�L' SI�61F �/k%l� �Ll�t•�1f�9'fE�� WHL f�='� <br /> C��n'f� 7c �Wy��N� 5���✓ Ci,2r�i/� <br /> NOTE: WIRING IN NON-DWELLIM�S;S RE�UIRED TO FEF. <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> I hereby certily that I have read and examined this application and know the same to be true dnd L � ��� — �l7 5 <br /> correct All provisions of laws and ordinances govemmg this lype o/work�vill be completed <br /> whelher speciGed I�arein or_noL The granting ol a permd does not presume fo give authority to <br /> violate or carcel lhe prowsons o/any other sfale or local law regulating construction or the <br /> peAormance o/co%str�cfio That 1 am authonzed by the owner o(this propeRy to perfonn the <br /> work lor which apphc fion :m de and 1 comp/y witli Ihe Sfate Confractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ll �—ZS-�� <br /> — S�gnature Dale <br />