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� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES G�4�'— <br /> 3200 CEDAR STREET, EVERETT,WA 98201 P��� J �G�� <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org 6R L� � �J� <br /> APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM 6 �1�C�n i i <br /> � � �a� � <br /> u ���� <br /> 3�0� � o�i a►� t1 J E ,�u w��,33�0 <br /> PROJECT ADDRESS <br /> �� C Li4�K 3 So7 W o�� � JE• �V ER CTi L.�� 9$ za �2s�� ��zz <br /> pyy�ef MeilAtltlre66 City 31e1e(Lp Phon� <br /> 7enanl Mail Addmss City Slatelzip Phone <br /> A � i,�c 3�-33t.-6�S8' <br /> �2p���J�J FtxcTW�- L?ooR���Ro+��l4JE w�T ��AvJe�J �.J�} `l8'273 <br /> EleeficalContredor MailAddmss ciry S�ah�Lp P�one <br /> A��CE2t co g� Ma� �.�soo ��o _ <br /> State Licence Number ContrecY Price of Work <br /> l��u,s< E�a��s���,,�,✓� <br /> Propoantl Uee of Bulidinp Contect Penon (Plen Raviow) <br /> Descriplion of Work to Bc Done: � � TT Q{�� � U'C� 'M���'�— <br /> N07E: WIRING IN NON•DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVEREtt LOCAL SALES TAX CODE IS 9106 <br /> I haeby certify Ihat!hm�e roed and axamined this epplicetion and know the seme fo Do t�uo and �I �� I ' i � <br /> correcf. All provisions ollaws and ortlinenees governmg fhiS ryp8 0l work w/11 be completld —� <br /> whothor apoci�od herein or not The gren6ng ol a pertnd does notp resume to g��e euMonry fo <br /> violate or cancel the provlsions ol any otber stete or locel law regula6ng conaMuchon or the <br /> performanCe o/construc7ion. Thaf I em gufhonzed Dy the owner o!thle property ta p Aorm fhe <br /> work!or whlch apphcetion is made end I comply with fhe StetB Conbectors Law 18.2�RCW end <br /> 290.200 WAC. <br /> ignature ate <br /> iGd i <br /> �� -, a- <br /> i����� i'�;I � �tl� l -�L-��l <br />