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JUN-19-201� 03 :5� FM EEC 12067434U37 P' O2 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT' PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-2F7-8810 - FAX 425-257-8857-www.everettwa.org (�_a0�f a <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM � �aD(�-II� <br /> � I 00 ��ere-�-f- A�_ <br /> PROJECT ADDRESS <br /> r �� n� �VPv2� 3�AL) Ced0.r ST EVerett W�+ 9��nl <br /> Owne� Mell Address City Stale2ip Phone <br /> � i-�i n-� �VeY'P'{� <br /> Tenent Mall Address City Stale2ip P�one <br /> Advnnced �P��pIPr L�C Po �ox r�no5 � �� _►-�W�aso�a ya5-���- <br /> Electrical Conlrador Mail Address Clly StelefZip Phone <br /> �}bYANPI_q1�51�8 � •`���0• (� . <br /> State Licenso Number Cantrect Price o(Work <br /> �,� �}- �}Q-�-;a-, ��_ Lnr�, l�orrah <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Description of Wark to Be Done: J n�Q�A ��11(��"n1"� l�_ ��� '� �h�1 I <br /> �.J <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. �� n GjO <br /> 7 <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3106 <br /> 1 befe6y certily thet I havo road and examined this epplication and k�,n�r;i�e same fo be troe anA <br /> conecf. All provisfons ollaws and ordinances goveminq fhis type ol work will be completed r 1 Z�(� � l( O <br /> � whether specified herein or not. Aie grenting o1 a permd does notp resume to give outhonty fo G � `�� <br /> violate or cnncel the provisions o/any other stafe or local law regulating constnichon or the <br /> peAormance af construction. Thef 1 am aufho�zed by the ownor o((his propeAy to perform the <br /> work Por which application is medo and 1 compty wifh the Stato Confractors Law 1827 RCW and <br /> 296.200 WAC. <br /> ���, , �'n � , �N�' /9�in��/�. <br /> SI al re �olo <br /> � <br />