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��_ <br /> ELECTRI�AL PEh�MIT APPLICATION <br /> CITY OF E�,'ERETT PERMIT SERVICES 7 �30 �07 <br /> 3200 CEDAR STREET, 'tVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org �'07b 7--( �� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 2'3� ml. �Q � �� c,� K . P� 2����r�y s�,a-e lo� <br /> PROJECT ADDRESS <br /> L.fl3 �N1�� 7S�S` �+�q��o.., R� fvr••rc,-�s w�- 9tizo3 ��'��s�cys-goY � <br /> Owner hlail Address Ciry Slate/Zip Phone <br /> �A !3 r N A L. S�c}-n, Q <br /> Tenanl R1ail Address City Slale/Zip Phone <br /> � ltic.�+s ��.v n� (�n.h� 121.� Ai�c��tc� �� MuJ�� Y ��.nt;,.� wfl CI��-l-j ?�>'�— ��6 <br /> EleclricalContraclor MailAddress Ciry State�Lp Phone <br /> DT�� ;:n.� cr �io �i�, .�� 1 �7: o�o <br /> Sta�e License Number Conlract rice of Work <br /> t�FF�ce �viM��s 4,►rTo <br /> Proposed Use o(Building Contacl Person (Plan Review) <br /> Description of Work to Be Done: W�,(Z� �a K�T � �A&LF <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> C�TY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily Ihat I have read and examined this applicafion and know fhe same to be true and <br /> correcL All prov�sions ol laws anA ordinances governmg Ihis type ol�vuik will be cornplefed <br /> whefher specfied herein or noL The granfing of a pennrt does nof piesume fo give authordy to <br /> violale or cancel the provisions oI any ofher stafe or local law regulating consWction o�the <br /> performance o/constn�cfion. That 1 am aulhorized by the o�vner o/this property to perfonn the <br /> work/or which application is made and 1 compty with fhe State Confraclors La�v 18.27 RCIh�and <br /> 29G.200 WAC. <br /> ����/ �S''� � "St�-�� <br /> Signawre Uate <br /> Cli � �i� �O � <br />