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JUL-11-206�E 09:34 FROM:PERFIIT 4257756315 T0:14252578857 P.4 <br /> ELECTRICAL PE MIT APPLICATION <br /> CtTY OF EVERETT P RMIT SERVICES '7 - tl_d� <br /> 3200 CEDAR STREET, ERETT, WA 98201 (yD6 d <br /> 425-257-8810 - FAX 425-257 8857 —www.everettwa.org �—b S <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT&�CREDIT CARDS ARE NOT ACCEPTE� <br /> �R / � ��4G�- l�r-�J� �C[ <br /> PROJECT ADDRESS <br /> �Zl'�ZS'�i �q <br /> Ca r l ��'t�t vi ��(��' !�l��z�r.�/' �, �i.��{� ��2a 3 <br /> Ownef Mail Atlaress City Slate2lp POone <br /> Tenent Mail Atldress City State/Zi0 _ Phone <br /> � �" ZQ� <br /> f�" '�b��I CF CcJv�f'� `� 'L�2 <br /> Electrical ConVactor Mail Address Clry State2lp Phone <br /> ��s�-�«1'q��dD 7�< _ <br /> State License Number Contract Pnca of Work <br /> .1��2 <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: <br /> l'tdl�1 Gt�_��_��° rLCfc7'� 7� 1�'t2�1� T� <br /> NOTE: WIRING IN NON-DWELLINGS IS REDUIRED TO FE� <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALE8 TAX CODE IS 9103 <br /> !hereby certily that I have read and examined fhis appqcatlon and kno the same to ba true and <br /> correct. All provisions o)laws and ordinances govemmg this type o(w rk will be completed j ; <br /> whether speciLed herein or not. 7he granting of a permit does nor pres me to give aufhonry 10 (\� � <br /> v�olate o�cance/the provisions of any other state or local law regu(atin constructlon or the ^�v I <br /> peAormance ol consfrucLon. That 1 am avthonzed by the owner ot this roperty to peAorm fhe � I <br /> work/or which application is made and I comply with the State Cont2c rs Law 18.27 RCW and O <br /> 296200 WAC. � <br /> � ��<� 0 /` '' <br /> Signalure Da�e � V <br />