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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES I���s.-07 <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org G�D.�a ��f 3 <br /> APPLICATIONS ARE ACCEPTED FP,Cin o�'+°1j TO 4 PM <br /> 32�i �f,x.aw �,,.. �, .��.r. �►a �gw� <br /> PROJECTADDRESS I <br /> Q�e�ch� � v� 1NlG,-� ISO(. I'�1c.r�ne. L�C IUC w� �sq8 71 ��y` <br /> Ownef 1 MailAdAress City Stale/Zip Phone <br /> y1/�4G 'Jc��nc..�d 1�n��vu <br /> C�1��� S�lu.}-�vns 3211 (3roadwwy Aw._ Eye,•[,�i G„ q �`� ?r01 ^��p` <br /> Tenant Mailadtlress CNy Stare2ip Phone <br /> �w(.��Mv:i�.� (� 1V1\l�✓ `7—ll� Vf.�/U (t' 1"11ti4 �(^7 d-Ch'`1� � W� S���S. �� <br /> EledncalContrador MailAOtlrese City S�ate2ip laJb� Phone �� <br /> � �b$-4�-18 <br /> �41ca�c�rn� �,� � f�F �/�/� 9 � l �od — <br /> Stale License Number Contract Price oi Work <br /> ��vhn.�.r � co.? — v F-F �c 2 Gre q /U o e.� <br /> Proposed Use of Buildmg Contad Person (Plan Review) <br /> Descnption of Work to Be Done: �01.+ Cr � �v��p V V ��}'c.�:C. T� YCr17T — CDy`�1¢.C7 <br /> � /1t VO«� � �✓t��n !9-CfEC�en (n ��� � l �.(�60Y ltil�\ IS <br /> NOTE: WIRING IN NON•DWELLINGS IS REQUIRED TO FEE <br /> 8E IN RACEWAYS, MC OR AC CABLE. I <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> I hertby certify fhat I have�eao antl examined this application and know fhe same fo be true and <br /> correct. All provisions o/laws and ordinances govemmg fhis fypo ol work will bo complefed <br /> whother specilied herein or noL The granfing oI a permd does nof presume fo give aufhonty fo <br /> violate or cancel fhe provisions oI any ofher sfa(o or/ocal/aw regulafing consfruction or fho <br /> pedormance olconsfruc6on. Thaf I am aufhodted 6y the owner ol this properiy fo peAorm the <br /> ivork lor which applicafion is made and!comp/y with Ihe Sfate Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � ---� cr��__\ \� 11- �s — o� �—D�3 <br /> --- -- 9ignature --- Oate �/ <br /> r- — __ <br />