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� <br /> ELECTRICAL PERMIT AF�PLICATION <br /> CITY OF EVERETT PERMIT SERVICES ���7_� I <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org ����� �j� � I <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM I <br /> 32 I I �3 r��.,.�,y .A � <br /> PROJECT ADDRESS <br /> K['.iG`'1�in /�IC��� ��C'� l�+�ccc��� �r A�� IlJ�or.t�5vi ��c� (�q �� `�7 � <br /> OWnEr MailAddress Gty StatelZip Phone <br /> �(r�o.c.()v ,u.l�l ilfl ���r 3� I I l3rrx�ux� /�� G�� telA �t�� ( <br /> � � p Phone <br /> Tenant Mail Aadress City Sta eZ <br /> C�t}5�77G �835 <br /> �iz.b„_-.��v i((eo.�-'��, Sys-�M5 �7`lDO �(-fcpr�e-�o.n Roa�, C�e,re�� �,JA 9g203 <br /> Electrlc�(Contrador Maii qedress City Slate/Zip Pnone <br /> ���rzaYNC.�85L 3 � 150 � <br /> State License Number Contracl Pnce of Work <br /> CL.._��.I:..� Lw•J �S 1 <br /> CaJ.t� G'1 C�a� <br /> Proposed Use o(Building Contact Person (Plan Review) <br /> Description of Work to Be Done: =f.h���� r� +<r.,� aN l ec� t e'cl "�r 4c .%�d'af �� � � <br /> J <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO ��V� FEE r i; <br /> BE IN RACEWAYS, MC OR AC CABLE. /�' `�. � J�i <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceRdy tlref I havo read and examined this applicafion and know the same l0 6e true and �G�11'�`� <br /> correct. All promsions ollaws anA ordinances govemmg this fype ol work will be complefed <br /> whefher specdied herein or not The granlin�ol a permrt does nol resumo to give authority tc <br /> violalo or canr.el the provisions o(any other slafe or local/aw reguPGng construclion or Ihe <br /> peAonnanco oI consfruchon. That I am authorized by tha o�vner ol this property fo perform fhe <br /> �vork for which application is mado and I comply wich the Sfate Contracrors Law 18.27 RCW and <br /> 296200 WAC. <br /> �;�'�,;� a/ �»� 3/ C�-1 O 7 <br /> `�ig�a urc Date <br />