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� �' �. 7�' <br />ELECTRICAL PERM17 APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.evereltwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />��l I �' "�O�wc.roo "��L <br />PROJECT ADDRESS <br />Q{HZIb 'I-4 <br />Owner <br />rvJ <br />Mail Atltlrass <br />cny <br />rolt <br />S�atdLp Phono <br />CI�fLi� To�+�� 5—//�� D06c.xa�0 ��� ��c�i �.,.v� 9�1d3 yGa-zcs-g��s <br />Ten. �1 MailAOtlrass Ctly Stato/Zip P�ona <br />i�t�vllUr(k[n5... �—ftru-ti z,� flaio N£ I.TNt� <br />Eleclrical Contractor Mail Aaamss ctty <br />f�D ��N � L qL <br />Slale License Number <br />SIU�:/�GE <br />Proposed Use of Building <br />�/L� <br />�L1GL/h�+U Ir� �!.'�J�3Y ��. <br />SUie/Zlp Phone <br />{� `��C� a' <br />Contrad Price of Work <br />Conlacl Person (Plan Review) <br />DescriptionofWorkloBeDone: ��SIrl�� 1'SE�yrt. yt� �t0�f,�er7 /j�t��� rjnrf. ����„e,/�LDA�r� <br />�i20 �W�r � T,�Srw�.. S�6.f�t� �:. /�cceSrdY TdcO(�. W�r.�t (i �P� 4 Sw � <br />.7 l.��u.- �✓r��� MD �2or (�fitrt..�. <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cerfily fhaf I have reaA and examined (his application and know fhe same fo 6e (rue and <br />correcL All provisions o/ laws and ordinaxes govemmg Ibis lype o/ wnrk wili be complefed <br />whether spec�ed herein or no1. The granfmg o/a permd does notprosume to give aufhonty fo <br />violafe or cancellhe provisions o/ any ofher slafo orlocal law regulatng opnsf�ucfbn or the <br />pe�formance ol cnnslruction. That I am aulhonzed by the owner dfhispo perly to perlorm fhe <br />work lor which applicafion is made and I compty wifh f6e State Contrac(ors Law 1 B.27 RCW and <br />29G.200 WAC. <br />/l-,� -OS' <br />FEE <br />L��c��2.'. `;2! <br />