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'J, �. 16. 2�_�i�g 1 : :;;F�'J NorlF �o���j Ele�t , � �; �0. 3('49 F'. 2 <br /> l <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES 3 —�6—P3 <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8957-www.ovorotlwa.org ��,,�9 j�3,,d� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM `�� <br /> ������ <br /> � S`3 0 �.U�� CAd..�. '0 Y \Vc- �� �� V�/�- ��� <br /> PROJECT ADDRESS <br /> K"a.S— aS"� <br /> 1ue�zd� Pc��� �LeC,. BU�. T�N�uV�l�ea I��t.,rl � �e�eh'�, u�A �ik�3 ���� <br /> Ownr.f Mall Addross Ciry SIa1dLp P��e <br /> � ' <br /> l� <br /> Te118n1 M�IIAddrest Clly Stale2lp �'_n o��V <br /> �� D <br /> (�uf�l�, Sc�,�,ti,1 71�e �cc ,U;v�c PL �C�ti �,�� ���f���,�� ��ncG �Xa�3 ����i <br /> Eleotrical Contratlor Mall nOtlrcas Ciy -� Slele2ip Pnone <br /> Y�U'(L1'1�5���-l '�1� � S0� '�DD �UO <br /> State License Number CONract Pnu�al Work <br /> ;�t-�,, - - _ �U Q � 1 �-Q.1/ <br /> .`: � <br /> Prr,posetl Usc ol8ullding � ConWG Person (Plan R�view) <br /> �escriptlon n(Werk lo Oe Done __��Q�l) .)-e��:�� �� A�y`�V�y,r � <br /> NOTE: WIRIN6 IN NON-DW[LLINGS IS R[�UIRED TO FEE <br /> pl:IN f2AC[WAYS, MC OR AC CAULE. <br /> CI7Y OF EVEHEI T LOCAL SALES TA%COOE IS�105 �Q U•, ;1 ..CJ� <br /> 1 baroby corhty 7haf I r�avo�oad and oxaminod Ihis eppl�ee6on mrd kncw fhe seme to be hue end <br /> I ) �y <br /> corrcct All p�uvisiona o/laws�n 1 vrdmancos yovomrnq(Irrs rypo al wo�k will bu complete0 <br /> whothor specdicd heie�n ornnf. �he giBnting ol e perm�f does not ��vsume N giw aufhonty lo <br /> wolato a cancol fho provrsions ol arrv ofher s�olo orlocal lew repu�ehng r.onshuc7ion o�fhe <br /> pudormancy o/construc6 That I am aufhorizod by tl�e ownor o/(Nis propeRy fo peAoim fhe <br /> �vork lp�n•b�Ch poliCahO i rnaAu and I cumpiy wilh fhu S(afo Conhac(ors Law 18.27 RCW and <br /> 790 2 'A(' / <br /> , �r � I �o � <br /> �9�mure ��� <br />