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i � <br /> ELECTRICAL PERMIT Q►P�LICATION � <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, W.4 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE NOT ACCEPTED <br /> � 9'G3 /. �G�G=(Z�'"%r �V�. ��T/�ZC-'T7r� W/� Q.��Z4 I <br /> PROJECT ADDRESS � <br /> 7 s•,rs 2o s y :z 3`- <br /> Hr"kii'-� ��/. lii�-�r�c�L�: J x��� FGclzCo2�iv'(n;,:]<� c,' .zr=�'r i�id 96zi3 .�YS-�:IS7 <br /> Owner Mail Address City State/Zip Phone <br /> �r7,=..�,ys �. q-.rv M . 12,$" <br /> tl�qrGy.N ST.<<.,wrlCc.v ��1 �l.<-?Z[yr /��/.: C. V�'F>T L1.'/-a `)b��r/ 2s'1' 17 �1`7 <br /> Tenant Mail Address City State2ip Phone <br /> C��v ��� �,�.,,� <br /> ElectricalContrectcr MailAddress City Slate/7.ip Phone <br /> � ;a �Sc3C�, c5� <br /> State License Number f� � + Contract Pnce of Work <br /> ��'C�GC'4:���-� ��U S-(' �) <br /> '� �-��" ,-?'� _ �•-..-- /'J-la L �/c..n-tC5 Q e= <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Description of Work to Be Done: L�C� r�7� Lr �= C��Lo-'7Z f,vt��d+� �c� �iY'Sr1sc�J�v(f,�_ <br /> �S�,v .�rcl��r ou �r-cC-7'J� .A-�n �i E.�i yi�rrv.�t�- i,. � "a/ 12Jo2 <br /> � �'7 <br /> �Cs�"-�ot ti' .5.='er' /,�•TTd-.-It� "'7> E7;-�C'Li - �LG'�'Tl"t e'a-e f�2M ��3 <br /> NOTc: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certi(y that I have read and examined this application and know the same to be lrue and <br /> correct. All provisicns of laws and ordinances govenung this type o/:vork will 6e comp/eted <br /> whether specr(ieti herein or not. The granting d a permd does not presume to give authonty to <br /> violate or cancel fhe provisions o/any other state or Iecal la�v regulating construcLon or the <br /> pe�formance o)construcbon. That I am authonzed by the owner o(th�s propeRy to perlorm fhe <br /> work for which application i:made and I comply wdh tie State Contractors Law 18.27 RCW and <br /> 2.96.200 WAC. <br /> '�_ ,� --- S" �/ �a,5— <br /> _ - �� c�� <br /> Sigpature Date <br /> L o5�s-or � <br />