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, <br /> ELECTRICAL PERMIT APPLICATION ; <br /> CITY OF EVERETT PERMlT SERVICES - ' <br /> o� _ y� 67 <br /> 3200 CEDAR STREET, EVERETT, WA 98201 I <br /> 425-257-8810 - FAX425-^57-8857 —www.everettvaa.org �'������Z � <br /> APPLICATIONS ARE ACCEPYED FROM 8 AM TO 4 PM 7G9J�-{�-f�ISZ <br /> a�� <br /> ;���ro ,�a�.� �l/���.�t, I/�l �'s-z�, i <br /> PROJECTADDRESS �— <br /> �/ 2 �] <br /> � , r `. I �'��,� . L�%� 3✓�[il <br /> Owner Sl-auY��` ' MailAddruss Clty Stata/Zip � Phene <br /> 'i« �IVXi y(Q t1. �-'��� �, , W!� %,'0/ �-9�l <br /> Tenant �S �/���V�.�1,L MallAddress ily siamiup rnu��u <br /> � � ��j L13f2 3ot+�-�SE l� � ' C�l Ls ��(o-tl � <br /> Eleclrical Conlractor ld Addross City StetalZip Phonc <br /> �3P.� Nk;�IS IU�'�E �1��9.°0 <br /> State License Number Contract Price ef Work <br /> A.� ���I U�����i��2� .�InILtYr��� U�l���C�j�� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description ot Work to Bo Done: ✓�I V���L�I L(.�v�/ �/l�/��I'- i�� � " ' �"' <br /> r i <br /> //��{��liSlC�l� �llJ'/�/Il�, <br /> � i� , �� <br /> NOTE: WIRING IN NON•DWELLINGS IS REQUIRED TO FEE <br /> Bf_-IN RACEWAYS, MC OR AC CABLE. ���GU <br /> CITY Of EVERETT LOCAL SAL[S TAX CODE IS 3105 <br /> 1 here6y cert��y fhat I have read and examined fhis application and know the same fo be true and <br /> correct All provisions ollaws and ordinancos governing this typv ol worL�vdl be comp�efed <br /> whether spos�6ed he�ain or no;. The granfing ol a pemuf does not presume fo give aufhonty fo <br /> violafe or cancel fhe provisions ol eny o(her stafe or local law regulafing consWcGon or fho <br /> performance cl consiruclion. Thaf 1 am authonzed by the ownerolfhis property(o pe�form fho <br /> work lor whic6 application is made and I compry�vi(h the Sfafe Confracfors Law 78.27 RCIh�and <br /> 296.20��C. . , <br /> �� ��� � �� <br /> Signawre Date <br />