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.o <br /> ELE�TRICAL PER�IIIIT APIPLICATION <br /> C17Y OF EVERETT PE.RMIT SERVI(:ES <br /> 32C0 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-6857•-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTEO FR6M 8 AM TO 4 PM <br /> Il a � SE �vere,�i' rVl� wa,� saa�2� <br /> PROJECT ADDRESS (,�a S,\ <br /> � � <br /> �107— 39z�� <br /> S n o�a c I� 2� �6 E vere,-�' /Lia9� w a.y �v evef}' �-'p 9 �og <br /> Owner Meil Atltlress Ciry Slate/Zip Phone <br /> P tlz._o s� Gv¢,--��f- rYtatl Wa., (yzs-, <br /> S ✓lo a-c �Zvo E�.erc�' wF1 `��'abT' �o�-�'YZ� <br /> Tenant MailAddress City SlateGip Phone <br /> "�l I "1 7c.�'rei i'�" � Sw �aC�6� <br /> ✓V1o.aDm�-,wld _V�ilLc,�- S.eR.-tK. (,•�Fl °�S'/�c� �6Y- �/.a..Z`X <br /> F.lec�rical COntractor hlail Address Ciry State/Zip Phone <br /> Vvt�bc. �om(= ��a f3 F ,�� � I��S 3 I =° <br /> State License Number I� �� Con�ract Price of Work <br /> Comn.u.w-t..� � � , Ec� A� a.ms _ <br /> Proposed Use of Building Contact Person (Plan Review) <br /> (a.osl ��ofs- 3�z(o <br /> oescriptionotworktoeeDone: Sns�"AII �3 ) Ne.tr oZ�% AM� �20 VO1� <br /> C l r[,u't�'S �'o ( �� c�u.(��.Q X rtC�-(�0.c,��2 S . <br /> � �IOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEW/1YS, MC OR AC CABLE. <br /> I <br /> � I CITY OF EVERETT LOCAL SALES TA%CODE IS 3105 <br /> II hereby certify fhat I have read and oxamined(his applicafion and know the same to bo Irue and <br /> correcL All provisions o//aws and ordinances govemmg fhis type of worY will be comnleted <br /> �,;lielher specifred horein or noL The granting oI a pemul does nof presume to give a,ithority to <br /> violate or cancel the provisions o(any ofh,er sfale or local law regulalino consfruclion or fhe <br /> peAormance o(c�nsWc6on. Thaf I am aufhonzed by the owner o/(his property to perlorm fhe <br /> �rk/or which applicalion!s made and l compty with the Sfate Contracfors Law 18.27 RCW and <br /> 00 W�C. <br /> ��� �— lo— S'— o� <br /> aWre Date <br /> �p aR-�p �poLl. <br /> E c7�o-pZ5 <br />