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I <br /> i <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �2 —/3�d <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org �-����,�a q <br /> / <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> -z�zs co�.3•� �Pv <br /> PROJECT ADDRESS <br /> v �-�:0� 3��.,.�z �-�w �.pt;e����;� s; Sp,.A c-�AMc;s�o ,c �`ty�o\ <br /> Owner Mail Addross City Stale2lp Phone <br /> ���;aN. �3.�,.�.�� z.�s 3 � cb�.a�., ���� (cJ:zR �� � � cN � <br /> Tenant Mai�nddress Ciry StaS I�PU' S33•7bA3 Phona <br /> Ya2(�o� S;c,-�..� C� . ) os� � ��� �P� O���c,�a,uv� �C�Gubo \ 't�'T �°� <br /> EloclncalCOntraclor Maillvldress Ciry Slale/Zip Phone <br /> ��Ro�,JSC�cn�N(3 Z s�p. � <br /> Slato Lir,enso Number Conlracl Price ot Work <br /> �� ' <br /> �� ;a�Z :�.a��h �.,�a; r�, <br /> Proposed Uso of Building Conlact Porson (Plan Review) <br /> Des�i�plion of Work lo Bo Dono: ,��i�-`(��.�C ��X�S 1� N�� �G.�Vvr�l��1 T= P <br /> �; Cr Z•t S <br /> NOTE: WIRING IN NON-DWELLINGS IS RCQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CADLE. <br /> CITY OF EVERETT LOCAL SALES TAX COUE IS 3105 <br /> I hcreby certify that I havo read and examinec'fhis application and knrnv tho semo fo be lruo and �1 L�� � � I "Z� <br /> conrcL All provisions o/laws and ordinances govenung fhis type o!work tvill Go complefed V <br /> n hefher speci�ed herein or noL The granting ol a pemid does nof presumo to give aufho�ity fo <br /> violate or cancel fhc rovisions ol any olhersfato or localla�v regulating construcfion orthe <br /> pe�fo ice o/cons i�n. T"hat 1 am authorized by!he o�vner oI fhis propeAy fo pedomi fhe <br /> �v !or�ti ich ap� cation made and 1 comply�vith fhe Sfate Conlractors Le�v 18.27 RCIN and <br /> 2 6.2001 AC. <br /> � � � I -Z�— �,1� <br /> SiynaWre Dalo <br />