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iu.zu :oiz o�:aa PdS 1�59593�JJa <br /> Ecersreen Secm•it�- �002 <br /> ELECTRI�CAL 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 B AM TO 4 PM <br /> 3 G�VYI �'1'CQ'�i" <br /> PROJECT ADDRESS <br /> ��r yU _[�� pcUe. 1.��32Cs Be.G'1 e.utti2 c,� �1.8�F <br /> OWnef MoitAddreas City State2lp P�onn <br /> �l rvL P�1�S <br /> Tenanl MaAAddross Gty SWIefLip Pnone <br /> �-f'LS`3'�S-�� <br /> L�v�e ►-e.e�'1 S�G(,i,+�i.a-v� 4's1,IS �c.�,�''�l-�b l � �sA `� �3 <br /> EleClricn anlraqor hWii mss Ciry U Stete2lp Phono <br /> �V���S�l �a�'a ' 2Cn55. � <br /> State License Number Contrad Price ot Work <br /> � res�.d.e,►�ha,l ��- m�.�,�,�_ <br /> Proposed Use of Building ��� .�,m,�� Contact Person (Plan Revicw) Q <br /> Descriptian of Workto Be Done: �'^ � ��.�VI��S 'tC7 Pi�G � �1� `s���v <br /> ��� <br /> � NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CI7Y OF EVERETT LOCAL SALES TAX CODE IS 3705 i Q � <br /> f hereby cortily that I have read and examinod thls npplicafion and know fhe sama to b�frue and � I� I U - � J <br /> correct. All provisions of la�vs and oMinancys yuvuming this typo ol work H•if1 bo comp/eted <br /> whofhor spec��rod horo/n o�noL Tha nranpng o!a pemnt doos no!p�sumo fo give authonty lo <br /> violataorcancelthe provis�onsolanyotherstafoorlocallawiegulahngaronsfrocfronor(he <br /> porformance ol conslroc6pn. That I am nuthonzed.by!ho ownerof Ihis p�nperty fo padorm tho <br /> work!or wl,�i'applrcation!s madc unv I comply wdh the State Contractors Law 98.27 RCW and <br /> 296.20 Aa <br /> s�Anat�m �au a�� - <br />