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1 <br /> ELECYRICAL PERMIT APPLICAT�ON <br /> CITY QF EVERETT PERMIT SERVICES <br /> 3200 CED,4R STREET, EVERETf, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> � BG�b OLyMP2� p� . <br /> PROJECT ADDRESS <br /> ,ae 9�P t z3 <br /> pR1 hnn�� C:,Ns,-, ��8 C. J1 rGh�.a....�a l,lce.�;,,cr�. w/1. �s-S 6s-�8s-B <br /> Owner Mail Address <br /> CitY State/ZiP Phone <br /> Tenanl Mail Address Cit <br /> Y State/Zip Phone <br /> ��.�h � u��r, ��� . �,� z„ � �7,�,,., (.�...q, 9Ew3G yLf-�,Z ��sy <br /> Eleclncal COniraclor Mail Address City State/Zip Phone <br /> �h�c.r�;E7�oI;k � <br /> �, Sa�. � <br /> Stale License Number Contracl Price of Work <br /> RESLpb"�.CF ?ztiLL1C 1CJ�-ML�,y <br /> Proposed Use of Dmldmg Contact Pcrson (Plan Review) <br /> Description of Work to Be Done: /� �-�+P !�tr�/� 52.1t a c_c..e. .�- /L�'c lw.,Lt� <br /> Cu M(�L� TT l��t.� 70 � TSLT <br /> NOTE: WIRING IN NON-UWEI_LINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE�5 3705 <br /> I hereby certily Ihaf I have read and examined Ihis applicalion and kno�v the sarne to Ge true and '� p�1L ,� ��� "� <br /> conect. All p�ovisions o/laws and ordinances govern�ng fhis fype o1 work will6e cornpletecl <br /> whether specilied herein or noL The grnntin,q o/a pemut does not presume to give aulhoriry fo <br /> violale or cancel fhe provisions ol any ofher sfate or lecal law regulafmg construclion or fhe <br /> peiforrnance oI consin�clion. Tha(I am aufhorized by lhe owner o/ihis prope�ty lo peAonn fbe <br /> wak lor which applicalion is made and 1 comply�:i::r fhe Sfafe Contractors Law 1827 RCW and <br /> �d6.200 WAC. <br /> ,� / 62 - o7- U � <br /> ( � Sic�nature Dale <br /> s <br />