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03/17/OS 09:16 FAR 2083786062 ADT fm00J <br /> � � <br /> � ELECTRICAL PERMIT APPLICATION � <br /> CITY OF EVEREIT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8610 - FAX425-257-8B57—www•evereltwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM 70 4 PM -DEBIT 6 CREDIT CARDS ARE NOT ACCEPTED <br /> �aNls` �dE�e� cvn-�1 <br /> PROJECT ADDRESS <br /> Dyy�gr MailAddress City SUb2�p Ph� <br /> ul�- AJE Gt�Es 4uK► /oyls EUt-xERt?�1 uM �� w'� <br /> Meil Addreas S1atelZip ^° <br /> Tenant ��ry '�lS'� -?W <br /> ADi �.�� � ,� R �,al,/ N�,�,�,.�4P��,;.�.� �1 �los ,��!!, tti��- yko�/ <br /> CI StataRip Plane <br /> ElectricalConlrador MailAtldress ry yz,s'-�f88 -5z�{y <br /> AorsEszdaz.os � �/.=s/o� ��_ <br /> State License Number Contract Pdce of Work <br /> Roe 't�i�r 9zs-�Fae•s:•p1 <br /> Pro�bsed Usa of Building Contact Person (Plan Review) <br /> pee,criptlon ot Work to Be�one: /�tT'�'�` �� ���a �ST� — <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS,MC OR AC CABLE. <br /> CITY OF EVERETT LOCAt SALES TAX CODE IS 3105 <br /> 1 here6y tertify fhaf 1 have read and examined Niis appflcatan and know the same to.be true and <br /> conecL All provisions ollaws end ordinances goveminq this type af wak wlll be comp(eted <br /> whether speclfied hereln or nof. Tho gran(irg o(a permR does notPresume to give aufhaity fo <br /> vidate or cancel the provlsions ol any other stafe orlocallaw regu ating mnshuetion orfhe <br /> peAormance af constiuctien. That I am authonzed by fhe owner o/thls property ro perfam Me <br /> . work lor which applicafion is made and I comply wifh fhe Stete Contrdc(ors Lew 18.27 RC W and <br /> 296.200 WAC. <br /> ���� �� 7��1 7�/oS <br /> SlgnaWrEi Dale <br /> Ec� �n36� <br />