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( � ' <br /> ELECTRICAL PEiZMIT APPLIGATION <br /> CITY OF EV�RETT PERMIT SERVICES <br /> 3200 CECAR STREET, EVERETT, WA 98207 <br /> 425-257-8810 - FAX425-257-8857—www.evereriwa.org q�6,..�1 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM GI��o g_l0 3 <br /> (U 33U �1lrrore2n �d i Sa;K � <br /> PROJECTADDRES <br /> Ownef MailAddress Ciry StateZp Phone <br /> (�J�'71n,....1. f�J� l.P�n2/ �U� 7�/�Vfln�eL°v� �.�2V �WLf ✓ fLIrP �' L.F7 „�[7sC/-i 1��� J��� �y�<� <br /> Tenanl Mail Address City Slate2lp Phone <br /> Nte�� ,• ccc .�J.3� 1 S r A,x S �/�5 �z �� Ul4' 9�13�,1 ;153-3o y-5 Sa5 <br /> Eledricd�ContfaC�af MailAddress City Stalellfp Phone <br /> nnC- �+2oc���s � o� � 7�Y • 3y <br /> State License Number Con ct Price of Work <br /> � J � <br /> 12e �a, oS� �i.,.�wb w 5 <br /> Proposed Use of Building Confact Person (Pian Review) <br /> Description of Work to Be Done: („aw,/J 21Y^ ��I�Z SI C'^tltiRL ro e�'LfJ�I V <br /> ���c i eY.� ,.+�a� � � s <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO F�E�� e �� <br /> BE IN RACEWAYS, MC OR AC CABLE. q <br /> CITY OF EVERETT LOGAL SALES TAX CODE 13 3105 <br /> I hereby ceRiry that l have read and examined this applicaUon and know fha same to be hue and ��I 0� � t O� <br /> correcG AIl provislons ollaws d ordinances goveming fnis type of work will be completed <br /> whether specified h in or n The granting of a perm�t dces notP resume to give author�ty fo <br /> violafeorcancelth provisfo ofanyotherstafeorlocallawregulatingconstrucNonorthe <br /> perlorman e ofco _truction af 1 am authonzed bylhe owneroffhis roperty to peAorm the <br /> work for ich ap rca6on i ade and I comply with fhe State Contrac�rs Law 18,27 RCW and <br /> 296.2 AC. <br /> � ^/l0 � /� <br /> Signalu D2t¢ <br /> Z�y:a6ed LS88LSz52bS��1 6L96SS9Bfj8 c�7�:W0Jd L0�L0 TS02-9i-d35 <br />