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( � � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES 5 -a1 --r � p� <br /> 3200 CEDAR STREET, EVERETT, WA 96201 E 1?.d r'J�O�I / <br /> 425-257-8810 - FAX 425-257-8857-www.evereriwa.org <br /> APPLICATION9 ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 13i5 E �� lar�ae �1' �ew � r <br /> PROJECT ADDRESS , <br /> ��CY'�C1� 1J2L'C�►(.G�^ S 'v—Nvl� <br /> Owner MailAddress City State2ip , Phone <br /> Tonant Ma(I Address Gly State/Zlp Phane <br /> yzr <br /> �z� 9 <br /> Ele cal ConhacWr Mail Addms� Gly StetelDp Phone <br /> ��"9�S" -- <br /> State License Number Contrect Price of Work ' <br /> Rt5 i��Q,Y�G(�. A�n'�nn.. 1 .....�pt� <br /> Propose�Use ot Butlding Contact Person (Plan ReWaw) <br /> Dascription of Workto ao Done: �D� �rv i c y+a ✓�AL�4 �+�'�� D t�'S,'�p � <br /> �u) ur ` �ov rn�f?�`���G O � a �rnw'�.�5? fq,lLbSP � ._ <br /> NOTE: WIRING IN NON-DWELLINGS IS RE4UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAK CODE IS 3105 <br /> I herebY csrtily that I have read and examined thls applicatlon end know fhe same to be W and � �� vS— v99 <br /> correcf All provislons of laws and orrilnencas govem�ng fhis lype of work will be comp/ete� <br /> wheU�er speellled herein or not 7'��e 9ranUng ofa per,nd does notPresume fo pfve aufhorrfy to <br /> violate or cancel fhe provisions of eny other state or locel law regu efing cortstrucfion arthe <br /> performance of consWcBon. That f am eufhaized 6y fhe owner o/�isproperty top r�n�he <br /> wOrk 1or which application is made and(comply wrth fhe SYate Conhactors Lew 18.2 GW and <br /> 296.200 WAC. <br /> -� / i3O�V� �%��G�Lx.P�i ��I��!Z.� <br /> Signatu e�8 <br />