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I <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 32U0 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 /> i�i�s MaRw � -N �-���- <br /> PROJECT ADDRESS <br /> s� ke� ZN �✓es7,,,.,1�3 Pv. (�o� iZcv S �.✓a,�{�,w/�. ��zo6 <br /> Owner Mail Address Cily Slate2ip phone <br /> M M� L`;oN � I �a`� %z l��.,� �/�h/�. �v���tf w/�- y Sza / <br /> Tenant Mail Address Ciry SUtelZip Phone <br /> cz�Mch'��S <br /> f 1�� ri� t�ZC��7'ic Pc�.BuX �'c s" �� wA Gi�v2 0 <br /> Electncal Conlractor Mail Addmss Ciry State2ip phone <br /> �Y,�Atitt 1677 � � ' /ZU�, <br /> State License Number Conlract Price of Work <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> �LN•i��"2G_ �/1�U%1�'���✓C �/ T / L <br /> Description of Work to Be Done: _ y ��twbZt' U y�L/�j <br /> hOTE: WIRING IN NON-DWELLING: !S REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby cedily fhat 1 have read�nd examined fhis npplicafion and know fhe same to be Irue end <br /> correcf. A/l provisions o(laws m�d ordinances govemm�fhis type o/work wi/l be completed <br /> whether speafied herein or noL The�ranfing ol a pecvut does not resurne to give authonty to <br /> violafeorcancelfhe provisionsclanyothersfa(eorlocallawreguPfingconstruc6onorfhe <br /> pedormance ol construction. Th�t I am authorized Gy fhe owner o/fhis property fo pedorm the <br /> work lor which application is made and I comply with the State Confractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> `�L��1�2� L_� � pL f—��_Q� <br /> Signature Date <br /> E o�v�l-c�3 <br />