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� ,\ <br /> EL�:�TRI�AL PERMI�' APPLlCATIOEJ <br /> LIZ'Y OF EVERF_�T PERMIT €��RVI�:1=5 <br /> 3200 CEDAR STRFET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8E57—www.everettwa.oro I <br /> APPLICATIO�S ARE ACCEPTED FROM 8 AM TO 4 PM � r <br /> Crl�j ?C/ .�----�------ <br /> P� E�D L S. n W C-c.�- <br /> Ownef Idail Address City State/Zip Phu9e <br /> Nu�s' ���, <br /> I �, ��c�n.� ��/ �,#-F �/�-_p�ee I,Ja re,� y.1 n � �"ao. 9%cb <br /> ena MailAddress Cily State/Zip Pho�e <br /> � n�- ��ec�-r+C � /3c�'tlS �ee'fw 2c� !�C)Ci.J CJl� Qc��3a- 3l0 �5�-i3v� <br /> ElectricalContractor MailAddress City S�ate2ip Pho�7e <br /> ,� � o 0 <br /> ��osN��y r�i��� �, $9� . <br /> Stete License Number Contract rice of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description ot Work to Be Done: � � W/ll.tX/{ %����i 1.1/�i .C�� ,/l,.l�l�� ��4'�� <br /> r-- � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> ��?. .� � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily fhaf 1 have read and examined this application and know the same fo be true and <br /> correct. Al!provisions o//aws and ordinances governing this fype of work will be completed <br /> wlietherspeci�ed herein ornot. The granfing o/a perm�t does not presume fo give authorify to <br /> violale or cancel the provisions c/any other state or local law regulafing consfruclion or the <br /> performance e/consWc6on. Thaf 1 am authorized by the owner o(this property to pedorm fhe <br /> �vork lor which application is made and 1 comply wifh the State Contracfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ,---� i. � � � - � ?O <br /> ;, .,, ;� :� � �� � <br /> � .o. <br /> -, ;, � ' _ ,�.�, �� � .�I 1 <br /> Signature Date <br />