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ELEGTRICAL P�RMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES C��a�,�/� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org 3 ,�ag„ �/ <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �D/6 R�,��w,4� EvF� c✓A. p�.zv/ <br /> PROJECT ADDRESS <br /> �C,N�c,o � cuoi� ����z aRo�av�ay EvE,�� w/� Y�.�o/ <br /> OWnef Mail Address City Slate2lp Phone <br /> �G�ALGffAN�✓EL oviaaor� 36v/ ��s S,��t�' r�.4 98i35' �•z6az3e33 <br /> Tenant Mall Addresa Ciry state2�p anone <br /> CLE�.G//RNti'�L o�r�a P.o, B�x s�97o3 sF,���m Tx 7�'.z.S9 1�� 6Y1 3�'33 <br /> [leclrical Contractor Mall Address Gty Stale2ip Phone <br /> CL tA,e Go 9y� ti/3 � ��.�� <br /> Slate Liconse Number Conlracl Prico o(Work <br /> _ B/LL130/�L" �r,f„/ /l�M/.:1n.✓ � S/D,Z��B <br /> Proposed Use of Buildinc� Contacl Person (Plan Reviow) <br /> Descriplion of Work lo Oe Donc: Iti�Cf:�,�t� 7���_(3�L,r�.ST /��T/ I��D F.�,/LF�✓ i��/1J HIT <br /> Il-f� f'u�+.� .+'1�'7�..Q . / ` d/l�Bo,htvl NM� �t/��''lBE,cs o.✓ �a�Cs. � <br /> ;v�a t F��t is 3;y� �:�= so��� F� �s 3/y7. <br /> NOTE: WIRING IN NON-DWEILINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> � S� �� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily fhat I have read and exnmined this applicafion und know the sarne to be fruo and <br /> carecL AO provisions ollaws anAordinances governmg fhis type ol work will be cornplefed � <br /> whefher specibed herein or nof. The g�.3nfinp ol a permd Aoes nof resume fo give authonty to l�U'�— 11� <br /> vio/ate or cancel the provisions ol any other slale or loc�l la�v renuPting cons(ruction or fhe <br /> pedomtance o/construc6on. That I am aufhoiized 6y fhe o�rner olfhis property to pe�form fhe <br /> work Ior�vhich applicafion is nrade and!cornply with fhe State Contractors La�v 18.27 RCN�and <br /> 29G.200 WAC. <br /> 2'�,___ 3 -z�-�f _. <br /> Sig atu Oate ' <br />