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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 /> APPLICA710NS ARE ACCEPTED FROM 8 AM TO A PM �I�O J-O 7!� <br /> � Sov M'FSti'�.L L'�k�C `1 IG N MI <br /> PROJECT ADDRE55 <br /> H1A S�F�At. 5,�,'1� k1x.'tlwGs I�vo urc,.�I�stS-1 K 5� �2� .S�l�'�i lF� ►-�A �f o 1 <br /> OWner Mail Address Cdy State2ip Phone <br /> J'�{Z. L oo LG G4£t�L' �t�l`1 ►.J <br /> Tenant MaflAddress Gty StalelZlp Phone <br /> �vFucfi�N `�o„�r - stis-r�r� 3Lzs �ss nA�w� � s.....-�, �src�' �a ss�s�l <br /> Electncal Contracror Ma�l Address Ciry 51ate2ip ' Phona <br /> ���t�ps� � ., �31Z uoa "� <br /> tate License Number Contract Frice of Work <br /> rt�,.� � `' , �G- � '�+ l�.l Ml1Cc��r Lo�•7et. ��1,3 <br /> 4�roposed Use of Bui ing Contact Person (Plan Review) <br /> Desaiption ot work�o Be Done: ��� 30 3P �— rsYvs�A:� �•�F1� �� �*��� � <br /> �s.�ac.19,'�t) `Dt�1��� �J ^�,llr�2t � 'rR,A�cfru?.,�5 'h�ls+lEAt ��'S� <br /> �t,�� ,c1,�1� a � �� p�a�`r,a��.,'taN4 '� 1+�,4rE�n+T. � <br /> NOTE: WIRING IN NON-bWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS,MC OR AC CABLE� <br /> CITY OF EVERETT LOCAL SALES T/Uf CODE IS 3105 <br /> 1 herebY cerir(y that I have read and examined this application and know fhe same fo bs frue and <br /> comect. All proNsions allaws and ortlinances goveming this type o(Work will be compieted ��� G�L,�. <br /> w eclfied 6ereln or noL The grantmg of a permrt does notP resume to glve aufhonty to <br /> v late o• ncel the p�ovi ons of any other stale o�loesl law regulefing conshuction or tha <br /> edorman of constn�cti . That I ar�ecV�o��'re0 by fhe owner of this property to pedorm!he � <br /> work lor wR h epplrcation mede acd 1 cor»pty with the State Conhacfors Law 18.27 RC W and `y�-�1 �¢+� � <br /> 296.200 W C. <br /> �•761, - )'?�-3 �r z <br /> aignaturo �a� �M'vv ���i 'J'S� <br /> �1�0�1-0� CP <br /> l 'd OZSS 'ON '�NI 'SW31S�S y3MOd N33y9y3�3 wazs�t llUb 'Zl 'd3S <br />