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Sep051409:32a Vickie 3606914838 p.t <br /> � • <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -�vww.everettwa.org <br /> APPLICA710N5 ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ��9 �,���� <br /> PROJECT ADDRESS <br /> i <br /> :1�c, � � ; ���. �a� �.�,�, ��-�v�- 9�a� i <br /> Owner Mall AdOre55 City Slate/Zip Plio�e <br /> TOqanl MailAdCmss Cily� Slale/Z�p Phone <br /> l,�J l�� �a��22�, �a f�C���C 5'�S�i4�tL`rE� �1�9�?�Z. . <br /> Etectrical Contractor Mail ACdress Ci1y StatrJZip Phone <br /> �D-�i -�B"3�'� <br /> L�l�� �..T la/c� 3L� g� � <br /> State License Number Contract Price of tNork <br /> !�_ <br /> Propnse�ding Contact Person (Pla�Review) <br /> Description of�Vork to Be Done: �� � �����%� <br /> •7CfJL� r�i.�-d�.� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO �EE <br /> BE IN RACEN.�AYS, MC OR AC CABLE. rO QO <br /> �� <br /> CITY OF EVERETT COCAL�ALES TAX CODE IS 3105 /��Iln - O �� <br /> 1 he�eby ceKi(y that!have read and oxamined this applica(ion and know!he same to be fnie and G U�/� <br /> correct. All provisions of laws and ordinances goveming fhis fype of work will be compleled <br /> whether speci(red herein or noL The granting o!n pennrt dces not presume fo give aulhorify to � <br /> violafe or cance!fhe ravisions ol any ofher state or local law regufating conslrucfion or the / <br /> peAormance ol consPruction. Thai l am aufhorized by Ihe owner of�h�s property to perform the /'�/-- 2 <br /> wodc(or which ap ca 'on is made and 1 comply wAh the Slate Confreclors Law f8.27 RCW and (.Ci(/ � �� � J <br /> 296.200 W C. <br /> . �. Gl/�� � $ a�l y <br /> i naWre Date <br /> I _G��.G�.--- G'���L�_,���i-��.� <br />