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U"i'19iOO13 Id:i4 I�AX 42531ii830 YAHNI?I.I. Ii1.liCTRIC I�j00'_'/001 <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 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � o3 � b <br /> �a3�2 O�r�_w� ��r,rr, � Qsaoy <br /> PROJECT ADDRESS <br /> y2S <br /> �iw�l�le �i��rr2c �lnN+cs !a0 �w Gvo,+�rf4�Yk,(l�ir� Sw�tziDO cuuc� w�982�N 9S32Bo� <br /> Owt,er MallAddress Cly Stale2lp Phone <br /> Tanant Mall Address Clry State2ip Phone <br /> � F.l,tict7uc y0lS s292 LkS�t,iu,S �/� 9�aS13 y2S"?3576 00 <br /> ElaCtrical ConVaclor Mall Atldress City � State2ip Phona <br /> V�✓��`�18n� 5�80. °° <br /> Stala License Number Contracl Pdcu of Work <br /> Necd sF2 Tirn �25-2gv � 3Z� �" <br /> Proposed Use of Buitd�ng Contact Person (Plan Rovlaw) <br /> Desc,�IpUan af 1Nork to Bo Done: �✓��L /VGw ZZ3D yS� �'1' S�� �'f �C�_9w�G� ,�_ <br /> —2�0�4 �.cr✓�'u . T—<rw-r <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> � BE IN RACEWAYS, MC OR AC CABLE. � /„ Q� <br /> U <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> 1 horoby certily that 1 have reod and examined fhls application and know the samo to be lrue a id �I 3D2 — (C{ "l <br /> comect. All provisions ollaws and ordinancos goveming thls type ol work will be complatsd lc�- <br /> whefher spoclllod herein or noL The grenOng ol a pormd does nof resumo to give euthonty fo <br /> violato or cancol fho Provislons olpny othersfate or local law reguPet/ng cons(ructlon or thu <br /> performanco o/conslrucflon. Thet 1 am authonzed by the owner o/thlsp roperty to perlorm fho <br /> �vork Ior wh/ch applfcaUon Is made and 1 compty wifh fhe Stete Contractors law 18.27 RCW and <br /> 296.200 WAC. <br /> �/�1�� � l s <br /> Ignaturo Deto T <br /> I <br />