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/v . i�i -p(o <br /> ELECTRICA� PERMIT /�PPLICATIQN <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 /> .l�'.2.2 Cv���� ,4,�e S��{� 5/j <br /> PROJECT ADDRESS <br /> Owner MailAddress Gty State/Zip Phone <br /> �3�'�•-t I �y �i Sa�(^�w�r�P 1'9'22 co�dyq�✓t E..e.rf� W-4 �t 5C2c l <br /> Tenanl�� MailAddress Su�}eSy Ciry State/Zip Phone <br /> ��-s:ae C0�7MJN;C�{,4�5 ?oc3oe �y�33 1'tIU Cnrle wA- 4�oi7 4zs-�s� _ oz i <br /> Eleclrical ConlraClor A1ailAddress City StatelZip Phone <br /> L�t5�5c �4G¢oS �kSoJ "_` <br /> Stalo License Number Conlract Prico of Work <br /> _o�L,�e �;� e t��:� Arl�.�s <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> DescriptionofWorkto�eDone: _�ro��(( t(� �Atk/ l�hv�.e �'ycl�s � q KI-�6 l3�-.�(z <br /> G•�„� � l �iSC �o<� n�+�h �4w�f� <br /> FiOTE: WIRING IN NON-DWELLINGS IS REC?UIRED TO FEE <br /> f3E IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> !hereby cetlily thaf I have read and examined fhis application and know the same fo be We and <br /> conecL All provisions of/aws and ordinances govammg this lype ol work will bo complefed <br /> whether speafied herein or not The granting ol a permd does not presume fo give authonty fo <br /> violafe or cancel fhe Imovisions ol an}�other stale or local Inw regulating construction or the <br /> perfom�ance ol construction. That 1 am aufhonzed by fhe owner ol this propery to peifomi Ihe <br /> work lor which applicafion is rnade and 1 compty�vifh tho Sfafe Conh.3cters Law 18.2i RC W and <br /> 296.200 WAC. <br /> [ �G,,.._� (�(fi'�-.. �v • !t�� <br /> Signalura Date <br /> L-=��,�rU � 3 c� <br />