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( ( <br /> ELECTRICAL PERMIT APPLICATit�n! <br /> CITY OF EVERETT PER�JIIT SE�ZVICES <br /> 3200 CEDAR STREET, EVERC'fT, Vi;> AA201 <br /> 425-257-8810 - FAX425-257-8657- :�n.�..z��r.rettwa.org Cv/,�� Z <br /> cJ <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM O�.ZO��.O d� <br /> c- <br /> �2A$ <br /> 3='����e�.4� ��-%-�l't�-�o3 <br /> PROJECT ADDRESS <br /> �� U2s�1'-l� <br /> ��.�,NA2-�cl-�� 3� ����r Q��..-�v�1k IA )A (7►�2-�')3 <br /> a^���� MailAddreas City State2ip Phone <br /> Tenant Mail Addrose City State2ip Phane <br /> . ��9�e rr��� �k2S-PI'dS=� � <br /> �lle+t�l� u.�- a8rx�s� <br /> Eledrical Contr br Mali Addreae Cky StaMfLlp Phone <br /> ��.�71C—\41 )\I `A�'W�•W <br /> State License Number Conhact Price o(Work <br /> Proposed Use of Build(ng Conlact Person (plan RSview) <br /> Description of Work to Be Dona: ` <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. �, �S-G� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3106 <br /> I hereby certily thaf/have read and exam7ned lhls application end know fhe same to be true end <br /> corracf. All provislons of laws and ordinances goveming thfs type ol work will be completed � 1 Zo 5-c��3 <br /> whetherspecified herein ornof. Tha granting ol e pe�m�t does nof presume to give aufhonty to <br /> violale or cancel the provlsfons o/any othersfafe orlocellaw rag�lating construction orthe <br /> peiformance o/constructlon. Thet I am euthor(zed by fhe owner o/thisp ropeKy to per/orm the <br /> worlr for which applica�ion!s made and 1 comply with the Stete Confracfors Law 18.27 RCW and <br /> 296.200 A . <br /> �— ��1 `1� <br /> Signature ,�� e -_ <br /> l00/l00'd 6b5k 0£�80 ZLOZIlO/50 LLOl698SZ4 6epol3np:ma j <br />