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c �-. <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.everetlwa.org �p -a.�{ ��l <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �� �O�/` � �� <br /> 61l� P�xs Dr. Ev�� 58'zo� <br /> PROJECT ADDRESS <br /> Fw�t S�h�l d;�� y"�3o C,11,. ��- Eve��' w�{,Sb�3 4z5 3!5-yaw <br /> Owner 1.1aI�Adtlress City SlatelZip Phone <br /> �'lad�csn E1Q.M�,�ct' <br /> Tenan� MailAdtliess Cily Slale/Zip Phone <br /> \/�I I•u � i c. IIoO �'`1em 11 Gt�1c. Pk�au �vudt W�1� 9�zo3 yZG-�lo7-0132 <br /> Elecirical niractor 1�1ai1 Address Clly SlatelZip Phone <br /> V aci�i��1A �l�� o'� `fo�7 <br /> Slate License Number Contrad Price of Work <br /> 'l+�st�tutlonal /��cr► �ur++�o.r 360-n'10-11 y7 <br /> Proposed Use of Building Cantact Person (Plan Review) <br /> Descnption of Wark lo Be Dane: TAS�6��atien oi �ew UG�iYtrv 'r?fAT W���ne AEld/Afi�� � �"Z <br /> OY eh �r ��� �/�� —]Q �i �Gf-� <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 /> I hereby certi/y Ihat!have read and eramined this applicafion and know fhe same ro be liue and <br /> cormcL All provisions of la�rs and o�dinances goveming Ihrs type ol work will be complefed <br /> ivhelherspec�(ed heiein or noL The gran(ing ol a pemul does nol presume fo give aufhonty fo <br /> violaleorcancellhe provisionsolanyofhersfafeorlocal/awregulalingconsWclionorfhe <br /> perlorman[e o/consfruclion. Thaf 1 am authonzed by tho owner o/this property ro pedorm the <br /> wo�k lor wnich applica(wn is made and I compty wdh Ihe Stale Confractors Law 18.27 RCW and //�� <br /> 296.200 WAC. /O� , I � 9 <br /> / / <br /> �� �� �o�2Y��11 � <br /> Signatu�e Dale <br />