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( <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.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> 73 iS b�yNt�c- ��-a_ i��y wti- 5'Szo3 <br /> PROJ�CT ADORESS <br /> ' os� aw=ter� �13 iS e�tiwu Da. ��W�+T w4 �I87A3 <br /> Owner MailA�tdress Ciry S�alalLp Plione <br /> I� <br /> Tenanl Mail Address Cily Stale2ip Phone <br /> BU+uc S�+E6t' �G PM6 '� IS6' 43io 19b^� Y S� UJnxauop�` Wh �)goi6 ��$'Z- $ <br /> [IectricalContractor M11ailAddress Ciry Staie/Z�p Phone <br /> &lncx5E9ll Q6' a2�B00-no <br /> Stale License Number CoMract Price of Work <br /> C-.u�{-� I St+�' <br /> Proposed Use of Building Caitact Person (Plan Raview) <br /> Descriplion ot Work to Be Done�. ^�T^• • 3%d AMP SE�-�C� 'a fsRi+tf�F+ �T' 1C80.�6 <br /> �JfXt�r.� ll�'Ttt �� � � [�fG, � in Pc5 '14rb �`> �� i CR1�JtYr _ <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE � <br /> BE IN RACEWAYS, MC OR AC CABLE. I <br /> CITY OF EVERETT LOCAL SAIES TAX CODE IS 3105 <br /> 1 hereby certily that I have read and examined Ihis applicatinn anA know the same to be fnie and <br /> correcL All provisions ol laws and ordinances goveming fhis rype ol work will be tompleted <br /> whefher speci(ed herein or noL The granfing oI a permrl does not presume (o give authonty lo <br /> violate or cancel fhe provisions ol arry other slafe or local law regulafing consln�cfion or fhe <br /> pudormance ol constniclion. Thaf I am aufhorized by the owne�o/this p�operfy fo pedorm fhe <br /> work(or�vh�ch application is made and 1 comply with tha Stafe Contrac(ors Law 19.27 RCW and <br /> 296.200 WAC. <br /> �_ y1�,l�s <br /> ,natu D31e <br /> �O`�{�OC — <br />