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( <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> %1E.fi1.�TEST/c. c..fFF /y09 dEGrJ/ Tlf�'✓E cvE,�ETr *-��r 9 890/ <br /> PROJECT ADDRESS <br /> ESr Qt,liE L �t�E,P�Tr u�/fi ��'�� <br /> Owner Mall Address City Stale2ip Phone <br /> .S�or1 F✓�re�T ��,� Sas�68'-9/73 <br /> Tenant Mail Address Cl;y StatelZip Phone <br /> GG E/Ec.>•CicJ .�,�� ,�i�A �/�3A6/!7R <br /> EleCtrical Conlractor Mail Address City State/Zlp PAone <br /> �'�-��F,�.� 9sSK� 3ooc. �� <br /> Sta e Licenso Numb r � Contract PricQ of Wi .. <br /> �3 T.44�PN,r�� <br /> Proposed Use oi Buildinc� Contacl Person (Plan Review) <br /> Descriplion o(Work to Do Done: rn � ���� �1�r fea S.e Cosu� w i'��l iaOrs.�r �I�r <br /> Sius�il� .rna �,r lr.Ca� noutli �i.. Alo u� �r�t.� 70�"' ou�/���,Sw/�`i.eS <br /> �� L����S � �D/v3 �a� l/ Jvo A-�,,,0 5',,.bv..w.� I <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certdy thaf 1 have read and examined lhis applicafion and know fhe same to be fn�e and <br /> correct. All provisions ollaws and orrlinances goveming Uus type of work will be completed <br /> whether speci�ed herein or noL TNr,granting o/a pemut does nof presume to give authonty fo <br /> violafe or cancel the provisions ol any ofher sfafe or local law regulating construction or the <br /> performance o/consirucfion. That 1 am aufhonzed by the owner ol this property fo pedorm fhe <br /> work Ior which applicafion is made�nd I comply with fhe Sfate Confracfors Lew 18.27 RC W and <br /> 296.200 WAC. <br /> /���7—Olo <br /> � � Signature Date � ���� <br /> � ��� <br />