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ELECTRIC;AL PERMIT �4�PLICATIQN <br /> ClTY OF E'VEE.�TT PERMIT S�RVICES� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �l�-� �JeYZGQ ..J �� <br /> PROJECTADDRESS �` Qo ��k4,M� <br /> z53-85s4 3070 <br /> c--� ��w��s�. <br /> 1'm� Pac��;o Rt�a� � (�ioo �nc Ila3! g s. l�'le�Nos¢ 17n. � Vis�w- CA 9Z0$� <br /> Ovmer MailAddress City Sfatc2ip Phor,� <br /> t�iL lo�.a�. i-�t"�� �2`7 �¢.-4✓na.�.. lf7�v.� K it'nc'T� I,JA- Zolo-778-8too I <br /> Tenant MailAddress City Stale2ip Phone <br /> s^-.�a���,�,��,� 5,g�'�Q,�.-� iz�,y N,�.�9 4�-z �.�„•,u�r W�- 9 8zo�/ �zs-z�s-is�- <br /> ElecMcal CoMraCtof Mail Address City Slale2ip Phone <br /> --r-��-�'z�c9��1 QK. <br /> State License Number Contract Price of Work <br /> .orkw�QrL� a,� K���.�ocl._¢ 4z5-z�s—�Slo'7 <br /> Proposed Use of Building Contact Person �Pian Review) <br /> DescriplionofWorktoBeDone: T �..n � t4 �,ti.e�.i����<<M tti.Bti.K'�-e� �4nriP � (L��rS <br /> ��i✓�e G� /l P �-i Pk�S7'�til �. W� 2 � �J Cn� <br /> —� <br /> a NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TU FEE <br /> BE IN RACEWAYS,MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 31U5 <br /> i hereby certity that I have read and examined this applicafion and knmv the same to 6a true and <br /> coirect. All provisions of la�vs and ordinances govemmg this type of�:oAc will be compfefed <br /> �vhether specified herein or noL The gra.�ting of a permd does not preswne to give authonty to <br /> violate or cance/lhe provisions of any other sfate or local la�v regulafing construcfion or(he <br /> performance of conshucfion. That/am aufhertzed by the o�vner of this property to pedoim the <br /> i�iork(or�vhich applicafien is made end I comply�vifh the State Contractors Laiv 18.27 RCtNand <br /> '196200 WAC. <br /> �> <br /> � 3-G-o� / <br /> ignature Datc . ��� <br /> � <br /> / i;�C%� <br /> �, � <br /> � <br />