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OG/!;/2D0� 10:0G 36073SE507 �£LA?RS CONSTnUC?IOti x277; >.eei ieei <br /> � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 h - J� -(' 7 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org �O 7b �-tj77 <br /> APPLICqTIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � ��j U U� V�1Q�a(1�V�i� \Gu1 �'( • <br /> PROJECT ADDRESS <br /> �t�uk a[�l�nrry4l' �v t�o�.53� �Qn�' l,U+� ���� <br /> Owner MaU Address Ciry SutelZip Phone <br /> $Da--� l,.)o�h gid�n • <br /> Tenant n�ail Aeere Ciry State2ip Pnone <br /> �0�-,33•� z <br /> �lU-i� t�s��r,t�. 2rt?�;�;�nvn i3`1�a.� �.��-19�2ti <br /> Etedncal Conhador Mail AtlErc�; City Sta�rRip �u� <br /> 6�Uar.LN�to 4 L� <br /> State IJcense Number Contmct Ptice of Work <br /> $GY� U1�h M�.-FF Gha..6�e_ _ <br /> Proposed Use of Buiiding Contad Person (Plan Review) <br /> Descnplion of Work lo Be Done: L�W ��Ll �'p�• - <br /> � �7 0� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> F3E IN RAC[WAYS, MC OR AC CAQLE. <br /> I �77�`; <br /> CITY OF 6VC-RETT LOCAL SALES TAX CODE IS 3105 <br /> 1 horoby crrti(y that 1 havo�ead and examinod this applrcatMn and knoiv the same ro be true snd <br /> correct. Al7 piovisions of laws and orclinances govemmq(h�s rype o(worfr wrll be compleeed � <br /> H�hether spec�ed herein ornot The giantii�o/n�icmrrt docs not presume fo give authorrty to ////// � n'�. - �/S%' <br /> vrolate or cance!the p�ovisions ol any oLier state or locall3w rogulating cVnS�uClion Or thg � J'',� , ,. <br /> poKom�anco o/construc6on. That 1 am auU�on:od,by(he owner o(U�is propeiiY to perform the ( ' <br /> work(or which applicalion is made and/comply�vrih fhe Stste Conhactprs Law 1F3.27 RCW and <br /> zss.zoo wnc. <br /> � �.I��'�d� <br /> — ignature �� <br /> ��!/ C'-G�LI I'`�� CC��IGf'1 �6 r / <br />