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JAN-c2-c009 21:10 From: To:2576B57 Paee:l'1 <br />ti <br />� <br />EL�CTI�ICAL PERMIT APPLICATION <br />VYCfT'Y OF EVERETT PERMIT �ERVICES <br />3200 CEbAR�STR[[T, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8657 — �vww.everettwa.ore <br />APPLICA710N5 ARE ACCEPTED FROM 0 AM TO 4 PM <br />'s:' <br />�.�. : � ? �'OC�C� c-c�-� 1'i'� -� <br />PROJ[C7 ADDRESS <br />Owner <br />� <br />Tenant1 <br />nr�o <br />EleGrlral Conlractor <br />Mail P,Jdress <br />S0�'V�o_ <br />Mail AdCreca <br />Mail Aaer9ss <br />So�rfP ��'��D7 <br />Stale Liconse Number <br />� J l n, L� - - <br />PropOSCd Use ol �uildin� ` <br />Gty <br />ciry <br />Cily <br />5131e/Zip <br />� �/ �5-�- <br />SId1E/Zip <br />i�, ��70► a� <br />SWtciZip <br />� ic� <br />Contract Prica of Work <br />ConlaCt P��son (��ti� <br />Descrlption of Work to ee Oone; f I.1t�V0 I I� <��� __���� <br />V � <br />Phone <br />Phone <br />Pnone <br />NO7E; WIRING IN NON•pWELLINGS IS RE�UIREp 70 FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF [VERETT LOCqL SALES TAX COUE IS J705 <br />I hereby ceRify fhaf I havo rend end exqmined this applicafiun and know fhe same !o be Irue and <br />coriecL A/l provislons ol/uws and ordinanr,es goven, �ny lhis fype ol work wpl be compictotl <br />whether spetilied here�n o� noL The gron(ing of a perrnd does nof prQsuqie to grve nulhonty (0 <br />violafe orcancel fhu piuwsions ol any other stafe orlocal �aw rogulaling ConsWclron or fho <br />podormance Nconstructlon. That l am oufho�mtl by the owner ollhis property to pedorm ,ne <br />wprk loi which npplication !s mad� anU I compty �sith fhe Sfnte Confroctors Law 18.27 RCW and <br />29G.2 WAC. <br />_ I�� �.Q�.�-- �I7 �I� � �a�°� �G <br />, .,,,,,,,,,,,,,, � � uate <br />��� ��.Q. �zs �� � -a5�� <br />