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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT. WA 98201 <br /> 425-257 8810 - FAX 425-257-8857 -www everettwa org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> /�� :�� � <br /> �?".:. ��c:nr H:���1 I51d%�i'(.� F^ernt t , fiA. . � � [i '��' / L�a c� � ' ' � <br /> PROJECT ADDRESS ' �' /�� ���'L�`��' I� � , <br /> �% fC��l Ci7!'✓ <br /> I•;.�..c�� . i .. . ' � .. .. .. ..�.��'_Cle i7:�ahlCgCc:: 'i�129 -0:5 �b� r':�-•-• <br /> Owne� Mail AtlOiesa City SIatMZip Phone <br /> i�c.:nq 1';. P2i: 3"]0"1 MC OIi-5r Scattic 'd�r.hington 981:�1 �i:'i-::S�i-GS'1'1 <br /> Tenant Man Adtlress C�ty Stateldp Phone <br /> F.iec[rir., LLC .. , V S[rcet l'ancouver Washingt.on 9Bb5! ?�-�) 459-5094 <br /> Electrical Con�ractor Matl Adtlress Cily Slate2p Pnone <br /> e�e.c�:t.•.,.,n�;t 7sor..aou.aa <br /> j State License Number Contract Pnce of Work <br /> Ai: Plann Fa�nc lian9a� .7im U'Ho'.,rke <br /> Proposed Use ol Butlding Conlact Person (Plan Review) <br /> DQSC�Ip11070(WOfk�OBBDOf1E k�.;u,�,rto n�inl inq taolt; and o.�utpin��nt. connoc: [e��pot'ary tailr: .� �.-1:. <br /> NOTE WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS. MC OR AC CABLE <br /> 5a,��s.00 <br /> CITY OF EVERETT LOCAL SALES TA%CODE IS 3105 <br /> 1 he:r,by Cerhll'fl r,i!1 h,7ve road anA e�arnmoA Ilns apphrahon and know tho sarno to be f�uo mitl <br /> con�cf All p:ovrs�ons ollmvs anAo�dmancos govornmg P��s type ol wo�k wdl bo complefed <br /> �vhefho�speahed horom or nof lbo y�anOnr�ol a permrf does notp�asume to g�ve aufhordy to <br /> vrolafe v r,ancel fho prnwsions o!any ofhor smfo oi local la�v rogulahng conshuchon or fhe <br /> perlonnance o�conshucfion Thal I am aufhorrzod by the ownor ol fh�s property to peAomi tho <br /> n�o�k loi�vh�ch app6cahon is maAr, and l compty wrfh fhe Sfa(o Confrac(ors Law 78 27 RCW and <br /> 296 200 lh'AC <br /> ;�/ X�- ;�Y,r-� l J/ �= l � '7�� <br /> ' /.. <br /> .� Signaluir. D �e � )�)�� <br /> � <br /> � � <br />