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ELE�TRICAL PERMIT APPLICATIQN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8ti10 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FRGiN 8 AM TO 4 PM -DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> lt �i2�-1 �irrnd�;.�i � <br /> PROJECT ADDRESS <br /> ��.r��u e.`\�t'Z[Xnn-� tt' ([�i�4 Viit:c;c�v, c��l � 'v''rri� �� r1 94 2C;\ �4L`S� 3`f=�5 5 <br /> Ownef -� � MailAddress iy j StateRi <br /> P Phone <br /> n \� l\ �' �I <br /> �U(1l'l.� 1.�1�tf�D�fLLC�1C'. <br /> i enant �-' Mall Addreas� City SfalNZip , ohnne <br /> 5t;ru'�r�l �A,Ca�tc' 2221 '�.A1',�r,�nirx �-t�CJtaIQ-11� Wh1 �����I ;� 2��_3lc�S <br /> clectncalCoMractor Ma�lAadress City gtatd/L - <br /> P Phone <br /> `:��N �T��czt� N � `I��a50.�� <br /> State License Number Contrect Price of Work <br /> �l�eS.\ � ��ll �\1 Vl1 -���11k� U�1�'l'1'7'lt' 1 Y �� <br /> Proposed Use of Buiiding Cantad�rson (Plan Review) <br /> Descnption of Work to Be Done: � �(h.��0.'t"i01' ��, � ' G1�L <br /> _SP1��r'�-h l <�USt�Yb�. <br /> v — <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO fEE <br /> BE IN RACEWAYS, M� OR AC CABLE. <br /> CITY OF EVERETT LGCAL SALES TAX CODE�S 3105 <br /> 1 hernby cerily that I have mad and examined this application and know the same lo be frve and <br /> correcf. All prov�sions ollaws and ordinanr.es goveminq fhis type ol work will be completed <br /> whether specified herein or noL The granting ol a permd does not presume to give authonty to <br /> violate orcancel the provisions olany otherstate oNocallawregu/ating cons(ruction orthe <br /> peAormance olconstruction. That I am authonzed by the ownero/Nis propeRy to pedorm the <br /> work/or which application is made anrl l comply with the Sta(e Contractors Law 18.27 RCV✓and <br /> 296.200 WAC. <br />� ����� ' <br /> ���-���- � �lo� I 200� <br /> � Signalure a�e <br /> �pS 13�-C�(1c� <br />