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�ia;l�!��'�+1? 1�:u3 253-631-7754 PROVIDENT E�E�TF'I�� PA6E 02/02 <br /> ELECTRICAL PERMIT APPLICATiON <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVEREiT, WA 98201 <br /> 425-257-8810 - FAX 425•257-8857–Hn+nv.everethva.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �q ► o ► s�r P1. �J � �ot �3 <br /> PROJECTADDRESS <br /> �{�nr11 o�.,�n G�i5ox IN r►�r Gc.cr.c C.Lf/'98a'SL 9zs-zlc8-9Kr l <br /> Oaner MailAddress Ciry State2ip Phone <br /> TeOant �,1ailAdtlress Ci1y $taie!Zip Fnore <br /> �s3�i��'L��-+�.��Z¢�7 C',ovtnat-an C�JA/480�iZ ZSS-Co3t�7T <br /> Gectrical Conlractor A1ail Address �ry State2ip Phore <br /> �ov.�S�o�Gz �' �;1��.�p <br /> State Licanse Number Contrad Price of Work <br /> tj�wt_(�'1i�lr.�e.�� — <br /> Proposotl Use ol Building Contacl Person (Plan Review) <br /> Descnption of Work to 6e Done: �� �^'�'Vt� �� �`-' � ��� _1� _ <br /> NOTE: WIRING IN NON-DWELLINGS IS REQLIIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. �Q, W � <br /> C____� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ccrtd}�Ihot I have read and examined this applrcatiun and hno�v;6o samc to be true and r I✓C1 C1- . I I G}- <br /> correr.L All provisions o�fa�vs and ordinances governing this!}pe ol�sork«ill be completod � <br /> �vhelhor specrfied herc;n or nnL Tqe granting ol a perm�t tlocs not presume fo give aufhonly to <br /> violafe or canr,el�bo provisions o/any other stale oNocal la�v roqulating constn�etion or the <br /> perlomtanco ol cnns(rur.fioa Thaf/d,n aufhodzed Uy the o�vner o`7Ris pr�pe�ly tu per(oim fho <br /> �vorkler u�hrch applicafion is made and I compty wdh 7he Stafe Contracfors Law 18.2i RCIM1�and <br /> 296.200 LL;�C. <br /> (Zf;�,,k�' y�����3 <br /> Slpnafu, . Uaie <br /> --_ — I <br />