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i;- � <br /> ELECTRICAL PERMIT APPLICATIO�I <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREE(', EVERETT, WA 98201 � <br /> 425-257-8810 - FAX 425-257-8857—wv✓�v.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �Ojp S� �vtSZ-F��" IM4c.� WA-'f � 201 <br /> PROJECT ADDRESS <br /> I <br /> �wner L9ail Adtlress Ciiy Slalc/Zip Phona <br /> ����;,�� �a c.� io�o s� �xru,R-V�nAc.�. �M�•s�- 6� zo�•3 Y3-610 <br /> Tenanl Mail Address �aCf r �ZO( Ciry State/Zip Phone <br /> EledflCalConlfaC�Of 1.1ailAdtlress City Stale/Zip Phon= <br /> ::AS'� L'tr�� . Slli'i�- � �,o <br /> 03o�ZY �� 12,.^T�.=oo0 0 N �,�000 <br /> State License IJUmber CoNrad Pnce o(Work <br /> ' �� �n ias� ,� 116 <br /> i����kl��- <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description o(Work to Be Done: `!DI(.e+ �- 0�� ���'�� ��V4.1-1�� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIREDIO FEE � <br /> BE IN RACEWAYS, MC OR AC C,46LE. <br /> . CITY O� EVERETT LOCAL SALES TAX CODE IS 3105 <br /> � I� !hereby certily fhaf I have iead and examined this aF�lication?nd knav fhe same lo be true and <br /> � correcL All provisions o/lar:s and ordinances governing this;ype of work�rdl be.complelea <br /> �vhether spec�6ed herein o ioL The aranbng o�a permd does not resume to give aulhonty fo <br /> � violate or cancel the prov s�ons ol any ofher sfa�e or local la�v reguPhng conswct�on or the <br /> peAormance oI c utru ion Thaf I am aufhonzed by fhe o�.ti-ner ot this property to pedomi fhe <br /> I. � �vork lor�rhich pPhca on is ry�de and I comply�vith Ihe Sfate Contracfors Lav.� 18.27 RCW and <br /> �� 296200 WA . / f/ <br /> I r � /�V <br /> . r..�aWre-- Dale <br /> �I. <br /> "� �Q� ��-o�y <br /> � <br />