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i , <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES 3_q_� -L, <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org �I Zf1'3—C��15 <br /> .4PPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �f2o �,4.R� P� . <br /> PROJECT ADDRESS <br /> N4,'�'� / _1 �?40(Lfl�AI !r-�+ PAr�c �L. �Jc!'�� 1.✓►'� 48d�3 ti�s��a 5 <br /> Owner Maii Address Cily Stale/Zip Phone <br /> Tenanl Mail Address Cily Stale/Zip Phone <br /> LI-6WEt.YN FLEcraic. �Hl'f Ga�O hvE EVERE� 1�✓Pt 987.U3 '�2�-7'�O-31DO <br /> � <br /> Electrical CoNraclor Mall Address Ciry State2ip Phone <br /> LL.EW Ee �E9 t90w � a375, �o <br /> State License Number Contract Price o(Work <br /> Proposed Use oi Building Conlact Person (Plan Review) <br /> Description of Wark lo Be Done: R EM o4�L B ��"rl R W�'I�UG' K�1�0 �'T�b� F`f�OSC� xN <br /> l.�J�►fIS �({ntn� . (ZE,PLHcE �X;Sr,�.ltr EL,EGTK�c• �AwrE/--. <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 v S� <br /> 1 hereby certily fhat 1 have read and examined this applicafion and know the same to 6e frue and r�� � <br /> correc( All provisions of laws and ordlnances goveming this type ol work will be completed �-�' <br /> whether specified herein or noL The granting o(a permd doos not presume fo give authority to <br /> violato or cancel the provisions oI any other sfate or/ocal Inw regulaling construction or the <br /> perfomiance o(construcfion. rliaf 1 am authorized by Uie owner of fhis property fo perform the <br /> work for which application is mado and 1 comply wifh the State Confracfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �j.,..� G�'�— c�?�o9�Zo�2, <br /> �� �— <br /> Signatur Da e <br />