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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES � 3 � d <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �/ <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org G��6�D -+q Z <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ,2 vo z 13 ro0.d w0.0 .�v� <br /> PROJECT ADDRESS <br /> Sx;f(, S��nsa .Z�z �1'�wa4 rvrrt�f �✓0. 9,�.2.0/ Y�.S- 15't •9z/ <br /> Owne�� MailAddress Cily Stale2ip Phone <br /> Sn y ss"' <br /> i tJ�S iQ ��orA161� /�J}v3 .t0o2 t,3row.�cJ.� avc Lr✓cl'G�'f" w� 98xr �S7 t lt <br /> Tenant MailAddress � l:ily Stale2lp Phone <br /> Qe.rrw els,pn S��y,�.� 7yo0 ��..roteson R.! Evtnf�" 'Gl4 �'Pao3 4sr' TT! <br /> Electricn C ntrector MallAddress Clry SWIe/Zlp Phone <br /> R.rrr. .lco &sL 3 2soO1 <br /> �at�e Lic nse Number Contract Prico of Work <br /> �+o Se.les K��y.. t-Eu� t <br /> Propused Use o(BuIlding Conlacl Parson (Plan Revlow) <br /> DescripGon of Work to Bo Dono: �' nl�P � POwCi` � Si fin ' ��J` I nS�A 1/ i S <br /> «�o/r�'� . <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> 8E IN RACEWAYS; MC OR AC CABLE <br /> CITY OF EVERETT LOCAL SALES 7AX CODE IS 3105 <br /> 1 hereby cerilfy fliat 1 have read and exemined this appllca0on and know the samo to be true end <br /> correct. All provislons o/laws and ordinancos goveming thls typo o(work wlll be complefed <br /> whofherspecillod herein or not. The granting ofa perm�t does nof prosumo to glvo nufhorify lo <br /> violateorcanceltho provisionsofanyofhersfetoorlocallawregu/atingconstrucflonorfhe <br /> performance ol consiruction. That I am authonzed 6y the owner o/thls property fo peAorm the <br /> work/or whfcli pplication is mado and 1 comply with Ihe Slato Contrectors Law 18.27 RCW end <br /> 296.200 WAC. <br /> C <br /> le �7 d� � ,������- ��� <br /> Sipn uro ale I �� � , <br /> � � � � <br /> �" �� <br /> L � <br />� - <br />