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i <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETf, WA 98201 (�j�-��-"�D <br /> 425-257-8810 - FAX425-257-8857-v�nvw.everettwa.org ��Do6 �/,1 <br /> U IAPPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> A�2�J Everar�en WQ.v Everett- w� qgzoy <br /> PROJECT ADDRESS <br /> S r�b�'10 M�S h <br /> P.u .D Cv�r�+�" <br /> Ownet Mai�Addross Cily StalelZip Phone <br /> CI ec��u� i r G 4 y o o ['a r ���cs,n P-I-. {:�r�lanc� (.v A 9Ra3� <br /> Tenant Mail Address City Stale/Zip Phone <br /> Ves-�rY,a�n lfo9s► ce�.ole 56.ar br, Powcsbo w� 31�� 1�9� 3aa-/ <br /> Eleclrical Conlrac�or Mail Address City Stale2ip Phone <br /> VC-STCa� 'nl �l�dPf� Z ,IiDO �j <br /> Slate License Number Contract Price of Work <br /> �.4 r� t c, C 4 u , P m-e n'i' ,��-F� �.o�1 2 Olo ^S7`� -�`�70 <br /> Proposed Use of Building Contact Pers (Plan Review) <br /> DescriptionofWorktoBoDone: Po�v2,r 'Pa C��arwi � P L'qU.��oN+Gv��- nq6r✓tGf <br /> a�kS �i'c� l..f "�'� �'imc�r . <br />� <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 certify that I have read and examined this applicafion and kno�v fhe same to 6e frue and <br /> correct. All provisions o(laws and ordinances goveming this type of work will be completed <br /> whe(her specified herein or noL Tho granting of a permd does not presumo fo give authonty to <br /> violafe or cancel the provisions o(any otherstate orlocallaw reguleting construcfion orfhe <br /> performance o/constniction. rhat 1 am authonzed 6y the owner of this property(o pedomi the � <br /> worlc lor which appllcation is rnado and/comply�vith the State Conlracfors La�v 18.27 RCW and / <br /> 29�.2��wA�. /D�� — I <br /> C� • !�a zo <br /> ' nalure Date <br />