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-- --l�---- !- -- -� <br /> ELECTRICAL PERMIT APPLICA�'ION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR oTREET, EVERETT, WA 98201 <br /> 425-257-8810 - �AX 425-257-8857 —v✓��,�v.evereiriva.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 Ah1 TO 4 PM <br /> ---------- I � 2 — <br /> � -� -z_2 N o ,��- � ,z-� ��t w q . <br /> PROJECT ADDRESS <br /> -��� �.., r-�5� �� E� �� _ ���A �Z� 2�Z�� 3 <br /> Owner Mad Adaress City Slale/Z�p Phcne <br /> —K—e—lcxT,,T- �F � sln9..i�n �.,�e.�c� wA. <br /> Tenant �J Afai�Aadress C�ry StatelZ�p Phenc <br /> �i. I \ <br /> Electrical Contractor Ma��Address Gty State/Zip Phone <br /> State License Number Contract Price ol WorV: <br /> Proposed Use of 6uilding Contacl Person (Plan Reviaw) <br /> Descriplion o(Work lo Be Dons. � J h Yl I V� e-\2 C-` C i C�`ti 1 � c7 �C� f(,�� _ <br /> NOl E WIRING W NON-DW[LLINGS IS REQUIf2ED TO 1=[E <br /> NE IN RACEWAI'S, �viC OR AC CABLF. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 f�ereby certily(hat 1 have read and e�.arnined tfr�s application and hnu�v the san�e to be true and ��/ Q(�- ��� <br /> correct All prows�ons ollaws and ord�nances novemin�fhrs type ci�tvrk�,all be compfefed <br /> whethe�specilied herein er nof The granfing ol a permd does nof �resume to 9ive au(honty lo <br /> violate ur cancel the provisions o!any olher slale or local law re9u�ating construclion or the <br /> per!omiance of construcfion. That I am aufhonzed by fhe otvne�ol this properiy to peifomt fltB <br /> �vork /o�u�hich app�ica(ion is made and 1 compty�vifh the Sfate Conlracfors La�v 18.27 RCW anA <br /> 29&200 Ih�AC. <br /> �C V� �5�`�^^� b / 8 � � � <br /> Siynat� � 0� <br /> I <br /> _ . ._ _ .__—__ ..- I <br />