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r-- <br /> ( t <br /> I <br /> ELECTRICAL PERMIT APPLICA.TION I <br /> CITY OF EVERETT PERMIT SERVICES � <br /> 3200 CEDAR S7REET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM e AM To 4 PM <br /> I���U CK,4f • L��.� Evcre(-�- 1J/� `l��Gy <br /> PROJECT ADDRES � <br /> OWne� Mail Address Ciy State2ip phona I� <br /> I <br /> I <br /> �cr��r..�- Clv;�rv��.�.. 52�rS II�LuEwcr�nr..�a,r _��e�-�' [..� 5 .�'� 9a5 -5ia-9cm <br /> Tenant Mail Address C�ry StatelZip Phone <br /> N�4r�� fl������C__ a��� is� ��,,L S.�Ivs xz� c.�A 9��a4 �53-3o�1-5ros <br /> ElaCiriCal GontraCtor Mail Address Crty State2ip Phone <br /> MEI�DEL.�r(6iDI� � �� � � " � � <br /> Slate License Number Contract Price of Work <br /> C1 r I � k- �C$� -+I MYV�C41� <br /> Proposed Use oi 8uilding Contact Person (Plan Reriew) <br /> Descriplion af Work to Be Dane: '^�M �ri 1 ��A I I�S'1 C'�{'lC �� <br /> 2lT� c, � l�� iS��C�PI �i �ll/.�.n�.. Cc�v •,�t Y� I. ��_irS ?r ��c"[ r <br /> NOTE: WIRING IN NON•DWELLINGS IS REQUIRED TO EE <br /> BE IN RACEWAYS, MC OR AC CABLE. I /\I e / � <br /> lJ lo <br /> CIiY OF EVERETT LOCAL SALES TAl(CODE IS 3105 <br /> 1 hoieby cortlly that 1 have road and ox�m/nod this application and knowlhe same to be frue and <br /> corrocf. All pmvisions ollaws and ofAinances governing Ihis ty0e ol work will be completed <br /> whefhef Sp6r,i�e herein ornot. ThEgranfing ol a permrt does not presume to give ButAor�ty f0 <br /> violaio nr ancel he provislons o/Any other state or focal law�egulating eonstn�ction or the <br /> podomia�co o/ onstruction. Th t 1 am authorizod,by tho owne�o!this Droporty to per/orm fhe /�� <br /> work foryyhich pplication is ma�e and 1 comply wdh the State Contrac�ors Law 78.27 RCW and <br /> 296.200hYA <br /> � � �3U—/� �oL�� <br /> , <br /> Signature Dale <br /> Z�ti;abrd L588LS25Zbi �°1 6L96SL9888 dN���OJ� 6i �2i Ti02-0C-Nflf <br />