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09i0fl/200i lO:dU FAS 1�125a0ifl0�^ GBDDIS ELECTRIC � 00: <br />ELEC�"RICAL PERMIi APPLIC�►TION <br />CITY OF EVERETf PERMIT SERVICES <br />3200 CEDAR STREE7, EVERETf, WA 98201 �,7 <br />425-257-8810 - FAX425-257-8857—�wvw.everettwa.org 3. �cFl r <br />APPLICATIONS ARE ACCEATED FROM 8 Ah1 TO 4 PM - DFB; i E, CREOff CARpS ARE NOT ACCEPTED <br />la � o o�J�.� q �'e e,� �tJa�,l -���•�tf <br />PROJECT AL�DRESS <br />�= <br />Uvna� <br />EG(l(.� �1iEr'zS�Y�"u,�fD �'�iUO � <br />n+au Add� <br />3 v-��e a, 5 a�a v�, <br />Tent7nt Mal Addrass <br />City <br />City <br />;; de�e,� u» ��a <br />s�,� <br />SWtol�p <br />�5 �le�fr��.��� a,��S-i31�, br�J� �-KStu�z.n5 i,�a <br />Electrical Contrdcto� � Maillvldrags <br />c;ry <br />s :�s3:�3si <br />Phone <br />phooe <br />98as6 <br />StaooZp Phonu <br />�f�5-32�-- <br />�L�Uz �s �q l f;� �5;5-Ov.�'° <br />State Licenso Number Contrad Price of Work <br />A-u:b P.�od-r., .`yFwt� Kctnd-r� �Edd i� <br />Propo:,ed Usa of Buildl g . Contad Porson (Ptan Reviaw) <br />Descripcon oF wortc to eo Dono� 1'� �C a�ti` i� J•"�"b OQ'�f / f�Y /ij Q-1 ��' f jCD'�'1 <br />d <br />_ 2, rilo�� �irCu��S �`� ir�i�� C1rCu,cfs <br />NOTE: WIRING IN NON-DWELL.INGS IS REQUIRED TO <br />8E IN RACEWAYS, MC OR AC CABLE. <br />GTY OF EVERETT LOCAL SALES 7AX CODE IS 3105 <br />I hereby certlry that I have rpad end examinod fhis appllcoflpn and know Ihe same fo bo trua and <br />correCi. All provlslo0s of laws end ordlnances govem�ng thls rype of wvr.'� wil! bp cCmpleted <br />wheUtsr spacil/ed herern or not The gmM/ng Q/ tt perm�t doos notp resume to glvo euthority to <br />Nolateorcancolthe Arovisialsolanyotherstetaorloc2RawrygulalingconsfrucUonorthQ <br />perform3nce oI constru,ction. 77tat! am au�oriznd by ihe owner ol this propeiiy to peAorm the <br />work for which applir,abon is mnAo a�d I ccmply widl the SYatri ContreCfas Law i8.27 /�,CW and <br />296200 WAC. <br />FEE <br />