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DEC-21-201� 09: 10 FROPI:C8M HERTING 425-745-1344 � T0: 14252578857 P:�'3 <br /> 1 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 32�0 CEDAR STREET, E'JERETT, WA 98201 <br /> 425-257-8610 - FAX 425-257-9857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> f�4 C'�s-r�t,v v� �r'z _ <br /> PROJECT ADDRESS �� <br /> I��nb�� �v�n�' 72� Crauah D,J ��2,��' W � 9 $�03 �l�i�S 82S <br /> pymo� MallAddress Clty Stale2ip Pnone <br /> Tenant MallAddrcss Ciry S1Bte2�p Phona <br /> ('a^� 4!�akir� Ir� i'-N5 Pxoa 1u�.0 C-veXe�i�' ���!g7,a1 �-25 Z�l ldd� <br /> Eloctriral Contraclor Meil Address ` Clry S�aierZip PhenB <br /> Cm14�M��qoti�4 �� lz���z l0 ���9 .oa <br /> Stnte Llcense Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Pian Review) <br /> Dtvcrtptlon of Work to ea Dona: ���� � G R . a � t <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERfiTT LOCAL SAL[S TAX CODE 13 3105 <br /> 1 horeby ceR;ty fhat I hsve read snd examinod this�AAlicaffon �9fld kRON'the same(0 6e trvo and <br /> cortoct. A7!provisrons o/la�vs and Ordinances goveming thrs type of worir wil!be comp7eted `�-�� �� _ ��—'� <br /> wlio7herspec!!)edher�ln ornot. The grsnting ofa permrt does notPresume to glve aufhaifym l•�I <br /> vfofeto or cancn7 tha provr'sions ol any othsr state or locaf!aw regu ating construcb'on or the <br /> poRbmiance of construcGon. Tbai!am�ofho�¢ed by the ou�ter of fh�s property to pertorm the <br /> �tivrlc for whrch appliceNon is maae�nd f comply Kith t7re State Contractors La�v 18.27 RCW snd <br /> 296.200 WAC. <br /> �p�hrQ �.u��.0 I ���� - i O <br /> —� Slgnature Date <br />