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ELECTRICAL PERMIT A►PPLICATION <br /> CITY OF f�VERETT PERMIT >ERVICES <br /> 3200 CEDAIi STREI=T, EVERETT, 1h'A�38201 <br /> 425-257-8810 - FAX 42E'•257-8857 —www�.everetlwa.org <br /> APPLICATIONS ARE ACi.EPTE[�FROM 8 AM TO 4 Pt.1 <br /> 2 bl G l<�T,� Crl�"'JG ��1C> �[VF1kT 1.11�1 `l'Pi1�`1 <br /> PROJECT ADDRESS <br /> �gA' i4`+��t.'�t �'r� lt� cnr,2wriy �x L,Lc ��7501 Vonl �Cc;lnn"t'�'� .nJr s�.is� ;s� <br /> Owner Man�ddress firy� State/Zlp Phone <br /> =��:�+'f, cq 5zk�4 <br /> uY(k-'2:�/`� 2�I e �.F�� Ca�+�o '�a�.�,� F1LF5tiKS�� 1 w <. $Lu`-� <br /> Ten2nt Mad Address Clly State2ip Phone <br /> x-vv-St.G�2rrZw t� w� 5�t5 j��-ST NL 3 C 7'� �� -'�A51[nw�;� w A+t 5+�,:,11 <br /> Elecirical Conlrector Mail Mdress City StelelZip Phone <br /> Zt1-'1St�(� Iv'1 �76�iti le�- "7T1�1� <br /> �Z/ET���f S�I`�i�L�1i- � CJ �rHoU.� <br /> State Liceise Number Cont•act Pnce of Work <br /> (.,,vMl1CM •��7i-L9- (� � S- � 1S� ��'1S� �-�S/G-.SI � <br /> Proposed Use ol Bmldmg Contad Person (Plan Review) <br /> Description of Work to Be Oone rS�3 =� 1� i P� — i�lvn„7.- -�.�(� �t�-kl.� <br /> NOTE WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IP�RACEWAYS. MC OR AC CABLE <br /> CITY OF EVERETT LOCAL SALE5 TA%CODE IS J105 fJ <br /> I hernby certdy thaf I have ieaA and erenrnreA fh�s applicabcn�nd know fhe same to be hi�e anA �- ���(� �'�� I � C <br /> corroct All piovisrons o/laws nnd orA�narrces goveming this tyPn ol work wtll be complefeA <br /> whefhor spaciGed herern or not The q�anhng ol i pennd Aoas rrot presume to give authnnty to <br /> wola�e or cancel fhe prov�s�orM ol any othw sfato or'�cal law re,qulahny conshuchon or fl:e <br /> pedonn�roce o!consfruchon� 7haf 1 am�1dhonlod o�fhe owne�ol this proparty W perform fho <br /> wo�c Ior«d7reh apphcnhon iq h�ada anA I�ornplv wdh tne State Contractors Law f 8 27 RCW and <br /> 296200Wi1C , <br /> 1 I r / � <br /> i. 1 �� + 1. � '� ��� '�� � � <br /> ignatme � � Daiq � <br /> G <br /> ; <br />