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EL�CTRIGAL PERMIT APPLICATIUf� <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 /> 10��� 5�c����+� ,c�<< I � �.��y � iv,� <br /> PROJECT ADDRESS <br /> Eu�:eff.e4�r� c�s{�,�e i��:l�l�HS LLC ro�e? �E cw�.=�+� .cl�.11 u��y broz �.:��f+, c�!4 ��ro3 <br /> Ovmer Mail Address City State/Zip Phone <br /> K;�tley-�l� Ass�,a�cs, LLC io�os�����,�� ,c��.n w�.� ��o,z e�:z++, ,��A q�ro; <br /> Te� Mail Address City State/Zip Phone <br /> .�J�'f��I /�li�fi.� �J�c�.1 J)//��G'tKJ 7��J �'IC!✓�C'�O.t KCttc� �t,'�'�C.'�� I.�L�,A ��t�� <br /> FleclricalContraclor MailAddress City StatelZip Phone <br /> t>�R;�YtiC�85�3 � I50� <br /> S�ate License Number Conlract Price of Work <br /> �j�� �� Gl���s�opL�r Cueris� <br /> Proposed Use o(Building Contact Person (Plan Review) <br /> Descrip�ion of Work to Be Done: .��:��� � '�`J n q`^�' Co.�n�c�1 �a �JOc:.�E(� ct� "� �� c�'� <br /> Ivts�ct ��G.'f io.\ <br /> NOTE: 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 certily that 1 have read and examined fhis applicafion and know fhe same(o be We and <br /> r:orrect All provrsions o//aws and orziinances yoveming tnis typs ol wod�will be complefed <br /> �;:liefherspecdied herein ornoL The granfing of a permd does no(p resume fo give aufl�onty to <br /> violafe or cancel Ihe provisions ol any olh�r sfate or local law regulating consbucbon or(he <br /> ;ro�lonnance o(constnic6on. That 1 am aufhoiized by the ownero/tfns property fo perfom�the <br /> l:�oik lor which applir.ation is made and I comply�vith the Sta(e Contracfors Law 18.27 RCW and <br /> 29G.200 WAC. <br /> ("/ � /JI' ; %l <br /> �C,�z. �,� -«,�;���� l0 �l�a��,,k(x�,� .r�o7 <br /> Signat�+ `u Dale <br /> � L'"i I 1-U�i `-� <br />