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1 <br /> ELECTRICAL PE�RMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, `NA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> I : ! . ` / <br /> /ao� L['D!/�i1,1Z}� ✓I� '�J�OI T-Si`f"�LL <br /> PROJECT ADDRESS <br /> �.�a�rt�� .7�����ti� /G�iGY� J,.�n��-����� �a��r�- w� <br /> Oaner MailAddrzss Ciry Stale2ip Phone <br /> Tenant MailAddress City State2ip Phone <br /> 11 � al M h dr 1 S 'r P ll Rn 7FAQ Radmnnd Urp qA074 475-AR�-910f1 <br /> [lectrical Conlractor Pdail Address City Slate2ip Phone <br /> � �%Y� <br /> UNIVEMS014KQ <br /> Stale License Number Contract Pr e of Wcrk <br /> �Y��,� ��Y�l�✓`� SasN,lf�1Ga %�5�$4r5-9/l�0 <br /> Proposed Use of� uilding Contact Person (Plan Review) <br /> � <br /> Descriplion of Work lo Be Done: !d��u� Tll� 1 �'���� ���� ��� <br />_ <br /> NOTE: WIRING IN NON-DWCLLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 5105 <br /> 1 hereby certily thaf I have read and examined fhis application and know the same fo be Vue and � <br /> cnrrecL All provisions o(/aws and ordinances goveming(his type ol�vork�vill be completed � I <br /> avhetherspeci(ied herein ornot The grantmg o/a pernut does not presume to give authonly to � <br /> violate or cancel fhe provisions,al any other sta(e or loca!law regulafing consfruchon or fhe , <br /> perlormance of constructior���•���am authorized by the owner of this properfy fo peAcrm fhe <br /> �vork Ior�vhich applicatiop�s + �-•��d 1 comply with the State Con!ractors Law 827 ljCW and <br /> 296200WAC. ,i�-� / <br /> �,'� i �"�� <br /> �; ���--- �i�"� _ _ <br /> Sgnature �� � � " <br /> �. ' . ��'.� ��� � <br />