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� � <br /> ELECTRICAL PERMIT �PPLICATlON <br /> CITY OF EVERETT PERMIT �ERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-25?-8810 - F�;:;425-257-8857—wwvd.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 pM q —�G -oa <br /> �0�6 —O /c� <br /> sl ��� FI�G ✓��a rep�� �.uc��/ <br /> PROJECT ADDRESS �— <br /> � S/� N C"7C ic S � ` <br /> , � ,��L�,�K���..� ��;,q . Yr ti <br /> � < <.Y�Cv<`«.... -- � C �- Ci�,5-� p ` 6c'� �j��j�' -_ <br /> Owr�r Mail Address <br /> /,/1S��fN �X���s� ��b / � Slale2ip �' 7 'Phone <br /> �/) �j ^� �IJr�...plf C,� CJp <br /> .�`C-�-�/CCL1✓'c�ti� ��/-�"� �' �/P."� rrr�,� �-�.y. 1U2C� <br /> Tenant `�� 6 n?��i l�— <br /> C�v1�l�res�i�'S� CitY State2ip �� � <br /> �� .,.�Phone <br /> �/< ��tf �"rl'�a - � �C✓� c�a�/ �L4� `��Ci3 c�;L2 7'Z c�/� <br /> ElecinralContractor ailAddress Qry State/Zip Phone <br /> S/!/1/1 ��'7� C�:�) �1 j `7 5"�) U <br /> State�License Number Contract Price of Work L�2j <br /> n� , <br /> :��, � �� �.T_,'�cq Gf.1 i u�.�� 2 z /zc, . <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: --�}}Sry�t �C.-�- (p<�� �j('f�N /��/ �L L �(�t 1 ��-�'.A('� (�G(C _ <br /> �<< iS — <br /> NOTE: 1NIRiNG IN NON-DWELLINGS IS REQUIREG TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CI7Y OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 7 [� � <br /> I hereby ceAi/y that 1 have read and oxamined this appficat on and know the sa����to 6e hue and �.� L�-1 V��� <br /> correct All provisions of laivs and ordinances govemmg tt is type of worN wil'bs completed <br /> whether specified herein or noL The granting of a permd a�es not resume tn give aulhonty to <br /> violale or cance�the provisions o(any ofher stafe or l�cal L=w reguPating conswction cr Il,e <br /> peAormance of construchon. That I am aufhor�ied by the�!wner of this property ro pedorm the <br /> work Ior which application is made and 1 comply with the S�ate Contractors Law 18.27 RCNand <br /> 29 . 00 WAC. <br /> ;l � � ;i�-G�� `� � na <br /> Sig ature Dat " <br />