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; <br /> �. � I <br /> , <br /> � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES ` <br /> 32U0 CEDAR STREET, EVERETT, WA 98201 ; - <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.�rg <br /> APPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM <br /> ///D8 � UF2 �Q��n� ��A�r _, �(�'�eF.T�' <br /> PROJECT ADDRESS � <br /> �q� �.°oPFi77'i�5 /1� �0 2f37 tALL F3'tiFAUE �{�0 Oi� Q ��oz <br /> Owner Mail Address� City State2ip Phone <br /> ��� G�I StatelZi Phone <br /> Tenant Mail Address iry P <br /> ��ow GbL��166�3s"�/u�fN C'£�uTAL Q� ���g�S��/ <br /> ���15 �N6'/.lJ���/N6 S'�'S�/L/�S f�'E� Lu,4 4�'ogZ <br /> ElechicalConif8Ct0� MailAddress City State/Zip Phone <br /> �i BS �. sv <br /> A C� . � �9 7 �e ��v .� <br /> State License Number Conlred Price ot Work <br /> �� ti�4 .vT L'-,��,r�o�� nJ <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: LUl.V �/OL'fl 6�' C J.UTRJL , /Q F LG�A 7�� <br /> T-S7A�"s /z) / - ii�'w ,(1C 2aoFZaP �,c,.tT c�J�2F ! <br /> T - STAT, — <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ceRily fhat 1 have read and examined fhis application and know the same to be fnie and E(�`(DO�"t�1 <br /> correcf. All provisions of laws and ordinances governinq(his type o/work will be completed <br /> whether speci(ed herein or noL The 9ran(ing ol a pemut does not presume fo give aulhonty to <br /> violate or cancel the provisions of any ofher sfafe or local law regolating construction or the <br /> pedormance o(construc6on. Thaf 1 am authonzed by fhe owner ol this property to peAorm the �i <br /> woik lor which applicalion is made and I comply wifh the Stafe Contractors Law 18.27 RCW and <br /> 296200 WAC. <br /> �.Ca//�P���.1.�/��� / � �O'[� <br /> Signature Date <br /> �o���- ��/ <br />