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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 4?.5-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> :�.� ��,�,// C�..�. �� w�.� <br /> PROJECT ADDRESS <br /> %�7v,.� !�,���a,a�'r �:s�-L,/1�, I Cr�r./ 0�,,,a� �t'..�rr G.�� y.�y <br /> VWner MallAddmss Cily T— State/Zip Phone <br /> Tenanl ".7all Address City Slate2ip Phone <br /> ��� �t"�e�� �J�/33'"�sreTF orT��, t..A 9b3Go 253-6�7-tfa / <br /> Eleclrical Conlraclor Mail Address City � Slate/Zip Phone <br /> G� �'/Z,�BDL�4 y/�o � /G, � <br /> Stale License Number Conlracl rico of Work <br /> Q � r- �_� A 4r �ti.nr5 r�`q��(' 4�3=870-8l70 <br /> Proposed Use o(Bulldinc� Conlact Person (Plan Review) <br /> i <br /> Description of Work lo De Done: �('� �„�y.7-T �//�5 �°1jQ/�.�� TjJ T�f L,1j�•Q <br /> /' —7� <br /> Ll�i�rr,,a.� T� �.1r7" o� �nol+o�,,,s ���� , � ��TG <br /> �g�^Avh . <br /> l � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 /' J �' ��, , <br /> I heroby certily fhat 1 have read and examrned this opplicnfion and know the sarne to be We and �v ( U(1 ,I ��? <br /> correcL All provisions olla�vs and orAinances goveming fhis type o(work will be completed <br /> whefher specified herein or noL The granfing ol a penm(does not rosumo fo give authonfy fo <br /> violafe or cancel the provisions ol an}�ofher sfafe or local la�v reguPting consWcfion or the <br /> pedomiance of construction. That 1 am aufho�ized by fhe ou�ner o/this property fo perfomi the <br /> u�ork lor which applicofion is made and 1 contpl}��vith fhe Sfate Confrectors Law 18.27 RC W and <br /> 29G.200 WAC. <br /> Sipnature � ' �/� <br />