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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA�J8201 g-3-3-o� <br /> 425-257�8810 - FAX 425-257-8857 -www.everettwa.org N��09�135 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> .��C� 'J l.J L(,lSii1J 1�G� �yS '- �� �✓Ci� W� ��f �-Ij <br /> , <br /> �ROJECT ADDRESS <br /> ����J '��l[Y �rJrAS�/U C � l q:A � <br /> �v � ��3 ) <br /> �ic'� nG{ \ �. �Pi' 150-�, Z �3U (?�ayc.�,�' uP w A `l � � �� y4E+-3y68 <br /> OWner MailAddress City StelelZip Phone <br /> 300 3 w Lc,)rC�u �',1 <br /> ��c �v�c�S���r L�t�v , E�c�e11- w✓l �� �i3 N/� <br /> Tenan� Mail Address Cily Slale/Zip Phona <br /> ��V�� <br /> 1�\a_c�o�,��c� V��,\lAr �7i�1 Ocl-� ef� /�,� St,, ;,e�.�L �l� `�k�ul� �'�8�y�7y <br /> EI¢cirical C�niraclor Mad AAdress Cily SlalelZip Phone <br /> � Ll�1C � orv�r- `l �a KF �/���I W y, 6`l� - <br /> Stato License Number Contract Prico ol Work <br /> ��-/1� � <br /> �`���v.n-�� � c c..� /Llc�r�. ��. � q —Ileb �70 <br /> Proposod Use of Building Contecl Porson (Plan eviaw) <br /> Description of Work to�e Done'. �l�I �� � �U�� ,/ ,� �� �',���� � �� ��-> > ������L� �� L�c � <br /> i <br /> ��VI�l � OW U ����-=,. t-1 � ��r�� ro� l . <br /> NOTE: WIRING IN NON-DWELLINGS IS REOUIRED TO FEE <br /> BE IN RACEWAYS. MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TA%CODE IS 3105 <br /> 1 hereby cortily fhat 1 have reaAnnAexemined this applicafion nnAknow fhe same fo be fn�o nnd <br /> r,nnect All prowsions o/laws and ordinances governing Ihrs lype o/work will be conrplefed <br /> whether specihed harein or noL Tho granfing ol n pornut does nol nosurno to givo nufhonty fo <br /> violafe or cancol fho pmwsions ol eny ofhor stafo or loctd law regul3hng conslniction or fhe <br /> p�Ao�mance o!consfrucfion. That 1 am aufhoritod by fhe owner ul this property to peAorm tho <br /> work lo�whir.h npplrcahon rs madn nnd 1 cornply wifh flre Sfefe Co�ifracfors Law 18.27 RCW enA <br />� ?96.200 WAC. <br /> � ' <br /> '•� c;.�.,_ � � "I - 2 i o9 \ <br /> igna ure '�i1�Zl/� -J OlL Dale ` _ I � ) <br /> ��r�l�� <br />