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� A' � <br /> ELECTRICAL PERMIT ARPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 / / <br /> 425-257-8610 - FAX 425-257-8857-wuvw.everettwa.org � �3 /Z <br /> APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM ���/`D�CC <br /> 3B Og '�1 rc 3d.�nv <br /> PROJECT ADDRESS <br /> yZ5- <br /> S a'as� `ZBZ4��c��c Q�a �v�.rv.�� u�A Q'8Z01 �� -3�o3g <br /> Owner MaiiAddress Cily State/Zip Phone <br /> �CA-. <br /> �SA 81oZ51Evasar�u:'�Z� � ���-� ►�A ��Z08 3_��77g <br /> Tenant Mai Address Cily State2ip Phone <br /> �/ZS - <br /> �� � = � � '� �1O�c< 1298 �v�c�.�- la)R 9�Z� 353-551Z <br /> Eleclrical Contraclot Mail Address Ciry StatelZip Phone <br /> d'J <br /> �� L � �� � ,�ZLZ 5O� <br /> State License Number Contracl Pnce of Work <br /> ���js_ilc�xc v_ <br /> Proposed Use of Building Cantact Person (Plan Review) <br /> Description of Workto Be Done: l�o�,.> V o\'t't�Q� �•���vUL'S 1! c��ce����— <br /> Tr��rr a:a�e��ti '� �Tuv1 �..�: � — I C7 �S ��-�J. �� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIREDTO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. �� pp <br /> � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby cerlily that 1 havo read and examined fhis application and know the same to bo lrue and � � � � <br /> conocf. All piovisions ol/a�vs and ordinances goveming this type o/�vork�vill be completed �"�� - (� <br /> whefher speci6ed herein or noL The granting o(a permit ooes not presame to give authonty to <br /> violato or cancel tho provisrons o/any other sfate or local law regulatmg construchon or the <br /> porfomianco ol consfruction. That 1 am aufhonzed.by fhe owner of this properfy fo porform!he <br /> work Ior�vhich applicafion is mado and 1 comply wdh the Stato Ccntractors Law 1827 RCW and <br /> 296.200 WAC. <br /> __._.y 1 'Z 3 - O I Z <br /> SignaW Date <br />