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0�/pE����B13 1': 18 L'5�-531-7i54 PP.OJIG�NT E�_EOTPI� -�aE l^/02 <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—w�w�.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �� �v (�lJ <br /> PROJECT ADDRESS <br /> Car�ru,f-�-'S�-��'b�• N��s (� $OX 1�1�I, Zy Mi Il C.r�k G�913oSL �1 z5-ZGS-99�I <br /> Ownet 1Vu.J��� Mail Atltliess City Slate/Zip Pnone <br /> I7enant Meil AdtltC55 City S�Me.2ip Phons <br /> t��cNi�c.�t�-rcl.cc�!'�te. P�J BnK 7087 C�Vi��^4-1��n L�-�-1 �O�IZ Z55'��L-77 <br /> clectrical Contractor C.� Idall Adems� Cdy V Stale2lp Phone <br /> t�l �v sE.s3113 GZ. $y� I 6 l .6� <br /> Stale Gcense Number Contract Pnw of�h'ork <br /> �L�,ML�V ��tC�lJ'�lL� �iYV� �I �'/l[�`\ <br /> Propose se of�u��lding Contact Person (Plan Review) <br /> � �c �: � ( '�� ��p�e,�QV iC,e�0�n� r�J f�i rtio. -�a� �� <br /> Descnption of Wo�c to Be Done <br /> �i/1Q�;(� 't� t�.�/ <br /> �.�,CT <br /> � i' . ,t <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FE� �� <br /> IBE IN RACEWAYS,MC OR AC CABLE. , <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I nrreby cerfilylhat/heve read ony oxaminod Niis application and Fno�v the samo to be true and �l��Z — �'�I <br /> conecf. All provisicns o�laws and urdinancos govenvng this rype ol�wrk�vdl be completod <br /> whether speciretl heroin nr noL The gr.�nfing ol a pormd does notp rosumo fa give authonty to <br /> wnlate or r.ancel lhe provisions of any other statc or focalla�v regulafing consWcfcn or thB <br /> peAoml�RCC OIC0f15(NCh0l1. ThDf 18R7 311ihonzed bythe owneroRhis propertyfopoAorm fho <br /> ivorR lor ivh7ch nppLcahon is mado and I comply with tho Sfate Contr&ctors Law 1827 RCW and <br /> 2�c zon�vnc. <br /> �'_%�����—�, FEa o s zo�3 <br /> � SignaWrc Uate <br />