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1 <br /> ELEC,�RICAI. PERMIT APPLICATION <br /> CIT��' �F EVERETT PERMIT SERVICES S _ �o- Ir <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everetlwa.org � ! I CS—C({� <br /> APPLICATIONS ARE ACCEPTEO FROM 6 AM TO 4 PM <br /> iin;r.,��r,n�� <br /> PROJECT ADDRESS <br /> Pu�;��lS.nin�ll�:idnr� l���nlrr IIM��I'a.Jr. �1��� Iv�rr❑ 1C4;'vR'l1I J"�'�q;l�r� <br /> OWnef Mail Address City Slale/Zip Ph� <br /> ti.��, , <br /> Tenant Mail Address Ciry StatefCip Phone <br /> Prc(crred lilcdric 9226 232nd StrmlSW Gdntands N'A,93020 206.499b691 <br /> EICCttiCal ContfOClo� Mall Address City State2ip Phone <br /> Pltl'.fIiP.1929P1. <br /> tii�.ire�ie� <br /> State License Number Contrad Price ot Work <br /> r,��t��y�,i.,� <br /> Proposed Use of Building Contad Person (Plan Review) <br /> \���c��I I;'IM):A`r•n�e�•.I'.�rAm��,G.�Ir.Pdi i�m�;Inl P�qr I i�;l�l <br /> Description ot Work to Be Done: <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. �_tina� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ,� n <br /> 1 hereby certily fhaf 1 bave read and examined fhls applicafion and know the same to be true and C � I�5 ��"I <br /> correct. All provisions o/laws and ordinances goveming this type ol work wdl be.canpleted <br /> whether specified herein or n 1. The granling o/a perr.id dces notp resume to give aufhonty fo <br /> violafe or cancel the provisio of any other sfate or local law regulating c�onshuchon a fhe <br /> pedom�ance o(construchwi. f 1 am authonzr.d by fhe owner o(fhis property to perlorm fhe <br /> work lor which applicafion is r a and 1 canply wdh fhe Sfate Contrectas Law 18.27 RCW and <br /> 296.200 WAC. <br /> . ❑In C <br /> Sig ture Dale ��� <br />