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ELECTRI�AL F�ERMIT APPLICATlON <br /> CITY OF EVERETT PERMIT SERVICES �S <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � _ v� <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 /> 1�3� s� ����eai- ,�t��u ���v ���,��� �q �������I <br /> PROJECT ADDRESS ` <br /> S-�PkL�R-t��" 4.uc���t1 LL� `�u�fll �itii r,ri�-- 5��. �'��� r�� 1 �'C�i1, �.A ��LLc) ���1 t3il C�I�O <br /> Owner Mail Address City Slate,2ip Phone <br /> ���Sr�cer� ����� u. 27TM f�Je. �oev,� �� `d�5CU�7 <br /> Tenant Mail Address Cily StatelZip Phone <br /> VCAIIe./ �12 �-�� 1�i�0 l�/1r'+��Il � �PNh [X✓h�.lav ��1ere-tt- lr�A- 41�2J3 �H,Z���{ol-r�'3L <br /> Eleclrica Conlractor Mail Address ity State2ip Phone <br /> URU,� EC�1�I ( dJl�- � � J�,'ZS3-- <br /> Slate License Number Contract rice of Work <br /> 1�P�1ti.1 ��l l)C�J�l <br /> Proposed Use ot Building Con�erson (Plan Review) <br /> Descri�,iiun of Work 10 Be Done: I�IS��I�!y.,l-+i�� �.k�(� ��(,�..��nc, �' �"i�'�S^"`C.�� f��C�� y�C1l ��� <br /> NOTE. WIRING IN NON-DWELI.INGS IS R[�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR F,C CABLE. <br /> � (,/ <br /> � �� �' � <br /> � � <br /> ICITY OF EVERETT LOCAL SA�ES 7'AX CODE IS 3105 <br /> 1 h�reby certi(y thaf I have read and examined this application and kno�v Ihe same to be Irue and <br /> correcf. All provisions olla�vs and ordinances goveming this type olwork�vi116e cornp/efed <br /> �vhelher specd�ed herein or noL The yranting o/a permd does not presume to give aufhonty to <br /> violate or cancel ihe p�o✓isons olany other state orlocallaw regulating construc6on or fhe <br /> pedormance o/construc6on. That I am aufhorized by the owner o/tbis property to perlorm the <br /> work!or which application is made and 1 comply�vith the State Contractors La�v 1827 RCW and <br /> 296.200 WAC. <br /> �'i1-C��, ��-..- ���IOS <br /> '�- � n iNre Dale <br /> � , �_ � � <br />