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,_� <br /> - � '. i'', '2 l: iu�',"� '(;. G�^_;, i <br /> _ <br /> �_� <br /> � <br /> i' <br /> � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES �Z �_ �� <br /> 3200 CEDAR STRGET, EVERETT, WA 88201 <br /> 425-257-8810 - FAX 425�257-8857-vrww.everettwa.org C�Z� g -�a 3 <br /> ApPLICAT10N5 ARE ACCEPTED FROM B AM TO 4 PM <br /> 1318 3�' S� Vn�f 33�4-� �Y �g`�o i <br /> PROJ�CTADDRESS <br /> �M �- �v n��/ PO���C?fi 5G,4vt � <br /> Ownef ' Mall Address Ciry StateJzip �hone <br /> Tenant � MailAddresu Ciry Stole2ip Phone <br /> Cm I-k�-�ina 1 �G I�}15Brc��a.� E,V , WRa��ol �ZS �� 6(�6(� ,- <br /> FleclriCalContraclor L MailAtldress City SlatelZip Phone <br /> i <br /> C�11 I-�M N�q�t Qq 250 "� � `` <br /> State Licanse Number Contract Prico o(Work <br /> Proposed Use of Buildinc� Conlact Petson (Plan Revigw) � <br /> Description of Work l0 6e Done: <br /> ��u�ex' --t� +�� ' � <br /> NOT[: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE , <br /> BE IN RACEWAYS, MC QR AC CABLE. �O C�l� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> !horeby ceRily fhof 1 hao's read and examinerl this�pP.�ication and kno�v tha ssme to be true anU � I ZL � _ I � � <br /> corrvct. All provisrons of la:��s and oNmancos 9ovorrong fhis fypa of work wdl be cornplrtfed > � <br /> whefher specifiod horoin or noL The granting of a pennd rlo�s nof presuma to give authority to <br /> viola(e orcancel fho prov�sions of anyotherstafe orfoca/la�v rogidaGng constiuct!on or;;,e <br /> pedormanco o(consl�uct.�on. Th,at I am aufhonzod by the owner o(ihis property to podonn fhe <br /> �vork lor v�hich application is made and I comp/y wi(h lhe State Confrac(c.-S Law 18.27 RCW anrl <br /> 296200 WAC. <br /> �io� ��.,��,v,,s $.a►�ia <br /> SignaWre—z �o�e <br /> !-- —_'—____. . . . . . . _ _ _ . ,..=.'gF:s.`"_'.?'__:� <br /> - �:��.:•� y . � , <br /> .,w i � . !v ,�,., -:�"i- '..,t . <br /> ,., < , <br />