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( <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVER�TT PERMIT SERVICES y_ �S_� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX425-257-8857 —www.everettwa.org L l/D�J���� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 3 2 Z� `om��za/ s9v� ��,�r�.�TT <br /> PROJECT ADDRESS <br /> �'�y� �-il-�iv��z ��ozo ib8� ,qi�- �li� 1��:�� 9�72�Zo6J�56 ��Zb <br /> Owner Mail Address City State/Zip Phone <br /> Tenanl Mail Address Cily Slale2ip Phone <br /> �'2�/t� ��C��ic• �/l� S/�t,e�a',t2 /,�v� �AEYmA �cg 4PB �s�6��-�3�o <br /> Elect�ical ConUactor Mail Address City State/Zip Phone <br /> C'2A�� �'6'.5��� � s� o� <br /> State Lfcense Number Conlract Price of Work <br /> �ie�r ��s�Y�4zs'�4�S%�9 <br /> Proposed Use of Building Conlact Person (Pian Review) <br /> 2 e�.oA. <br /> Description of Work to 8e Done: ���� 5,�,�(/lE'E r' �/�%�!-2�G �»��i �f���'��• <br /> -� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SNLES TAX CODE IS 3105 /( � �L(, � (� <br /> 1 hereby cenify that 1 have read and examined fhis application and know the same to be true and �� <br /> correct. All provisions of laws and ordinances govarning this type o(work will be completed <br /> whefherspecifled herein ornoL The granting o(a permd does nof resume to give authonty to <br /> violate or cancel the Provisions of any ofher stafe or local law reguPating consWction or the <br /> performance o(construction. That 1 am authonzed by the owner o/this property to perform fhe <br /> work tor which application 1s made and 1 comply with the State Confracfors Law 18.27 RCW and <br />, 296.200 WAC. <br /> ��CL�I�"� -lf�/2>/l� <br /> Signature Dale <br />