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253-981-9996 LIne1 . 09�.43:58 OS-09-2017 � �� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 S ` n `� � <br /> 425-257-8810 - FNC 425-257-6857-www.everettwa.org -1 <br /> E ra-os-0 53 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �-;�� (0 3 ?�n �l� • �-�-na �-o� <br /> PROJECT ADDRESS �a�-_ 3 <br /> p �X - 3�0�1 Sre rn� u��'�)�� ��c�0 <br /> OWnef Mall Addross � City Slele/Zip �P�one <br /> C�Yh Q <br /> nant �Aen nddress c�ty Slale/Zip ^ �Pn�$ � <br /> Cbr�Ylmun��awc �a�A�- S�cs3 ��- 1��- q�D3a-P lQioo <br /> EledAcal COn�reclo� Mall Addross Clry Slote2ip Phone <br /> �"�WS��q� 1M� � �j�o0 <br /> State License Number Contrad PAce of Work _ <br /> �t�a.h Sc.h�-e-�-�. <br /> Proposed Use of f3ullding Cont t Pet� �Ian Review) <br /> Oescriplion o1 Wo�k�o Be Done: �� l��� - - <br /> � � 3a 9�F Co I�� � ��C�-o��. �0 3- - - <br /> b � _�_ <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO F[E <br /> BE IN f2AC[WAYS, MC OR AC CABLE . <br /> � `•1 <br /> CITY OF EVERETT LOCAL SALES TAX CODE 19 3705 <br /> I hero6y carti/y fhol I havo read end exomined(hls epplication and know the seme to be frve end .. � �- � <br /> correcf. All provismns of laws and ordlnances goveming fhis type oI worir will Ge completed r I ZQ � — (7?� <br /> whefher specified heiein or noL The grnnNng ol a permit does nof presume fo Aive nutlrority fo <br /> vfolefa or cencol fho provrsions ol eny ofher sfefe oi local lew regulafinp consfruction or(he <br /> pedo�mnnco o!tonslruc6on. That I em aufhorized by fhe awner a/fhis property to peAom�tlio <br /> work lor which aPP��cation Is made end 1 wmpty wffh fhe Stnfe Confrac(ors Law 18.27 RCW end <br /> i 296.200 W�C. . <br /> .�oL�`Y" ' � �� " l� 1 , \ �. — <br /> � Uale � <br /> ignaN�e <br />