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ELCCTRICAL PERMIT APP'LICATION <br /> C�TY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 C{ �� D—�� <br /> 425-257-8810 - FAX 425-257-8857 — www.everettwa.org C�g0 y_J�� <br /> APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM <br /> LO 1 G � aK.�c9. �vcv�� G� �� Z� � <br /> PROJECT ADDRESS <br /> � �, }i (r�c,�9,F'r,� �51�, 32b'13 Q <br /> �� �O IC, � (�� ,N �- z <br /> Owner <br /> A1ail Addmss Cdy Stal HZip Phene <br /> Tenan� 1_� �c� A1all Address Cily State2ip Phonc <br /> �v�1.L1110 C.�J� <br /> ��.\ �— nur���l � ��� ��-�� _ sw� y i�h2� <br /> [leclrical Contrador Atail Address Cdy 'tate2ip Phene <br /> I�� ��1_I 1 � ��11..�T� l��[,Uz� <br /> S�ate License Numbci Contract Price of Work <br /> + IZ ei.r.� ����H�r.� <br /> 1 �IC�N d��t�-\ <br /> Proposed Use of�uilding Conlact Person (Plan Review) <br /> Description of Work to Be Done: n �t� '�61�i� i2���^�%�l' ` �'t' ��e��\�''�'� I�\Sct� W��L'- U�"� <br /> (o�� u��\�.� �.r�Q,._. - 1 1�,;, L,e, �- �1 .,,,��, 23Lc, S��. <br /> NOTE: WIRING IN NON-DW[LLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABL[. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> 1 hereby cerlily that 1 have rvad and exarnined this applicafion and know ffie same to ba tnie and <br /> conecl. All provisions o/laws and ordinances aoveirun�fhis t}�pe oI work will be completed , <br /> �vhefhe�speci6eAherein or noL The gran(ing o!a pernut Aoes nol resume to give aufhonty to <br /> viola(e or cancel fhe procisiens o/any ofhor sfafe or local law rec�uPfing construcUon or the <br /> pe�forrnance o(cons6ucfion. Thal I am authorized by(he owner o�this property(o perform fhe <br /> work lor which applicafion is made and 1 cornply�+ifh the State Centracto�s La�v 7827 RCIN and <br /> 296200 11�AC. � <br /> � ,7 , / -� 3 S <br /> �C��� ��C�.z� � ,� �`/ <br /> �� � �,� — Uate <br />