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�— <br /> ELECTRICAL PERMIT APPLICATION I <br /> CITY OF EVERETT PERMIT SERVICES i <br /> 3200 CEDAR STREET, EVERETT, WA 98201 I <br /> 425-257-8810 - FrUC425-257-8857-www.everetriva.org <br /> APPLICATIONS ARE ACCEPTED F{20M 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED I <br /> I <br /> i <br /> G(o�7 ��'� ��!\�1tvu 1�C>i�Y ; �� � Y_� � <br /> � <br /> i <br /> PROJECT ADDRESS <br /> ��t�,o�� �._�F �« - ��,�� �� � r��,�Nu �� „ �-r� �vtYt��'� �'z �� <br /> Owner Sl�d AtlOreae Clry Suie2ip P�one <br /> �I\Mc� �`_� /1t'�VL ! <br /> Tecant Mad,�ddress City Sia�ei2ip Phone <br /> -�'Q 1 ti1G_ �LtiC C�'1 L l=�?:C i `->E� 7(o�i ��� �l LLL VI.IE N/��t ��"L�ti� i <br /> Electrical Contractor Mn��nacress Clry Su�aZlo Fnme I <br /> n `h <br /> Y�2-�M� �'-1 l��`fi'i�;� ����- <br /> State license Number Contract P�ce oi`Nork <br /> Proposed Use of Budtlmg ConiactPerson (Plan Reviow) <br /> Descnption of Work to Be Dane: �—� LN1 � �-X���\ �N�� � i ��-- uY� � <br /> NOTE: WIRING IN NON-0WELLINGS IS RE�UIREG TO PEE � <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> i <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS »OS I J I <br /> 1 hereby cert�/y fhaf I have read antl examineQ;his applicahon and know thn same to De true ana I <br /> cor2cc All provisions ol laws and ordinances govemmg f��s bpe ol work wdl0e como�rtad <br /> wnether specdied herem or noG The yrantmg ol a pe�mR aoes not oresume t7 grve nuthonh� !o <br /> uolate or cancei the provisions oI any o(her stafe urlocal�aw regulat�ng conswcfron or the <br /> peAonrr ce o/ConSfrucfion. 7het�am authonzetl by the ownei o/fhis p/vpBrty to pBAOim t/�B <br /> wo Por hich app6cauon �s matle and I compry wdh the Slare Contractors Law iH.J RCW and <br /> 2 .200 AC. <br /> i � <br /> � � <br /> 7 � S, ..i�'r' l`�— �����-> <br /> Signature �Oale' : <br /> I <br /> ���(cU� C, >� ' <br />