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03/�1/�E13 14:14 253-631-7754 P�OVIUENT ELECTBIC P4GE 02/02 <br /> i --�-----. �— ------' � <br /> �', ELECTRICAL PERMIT APPLICATIOR� � <br /> � CITY OF EVERETT PERMIT SERVICES <br /> i 3200 CEDAR STREET, EVEREI"i, �NA 98201 I <br /> 425-257-8810 - FAX 425-257-8857 -v✓ww averettwa.org <br /> APPLICA"fIONS ARE ACCEPTED FROM 8 AM TO 4 PM � <br /> _ I <br /> 99�3 s5r P�c�J ' <br /> PROJECT ADDRESS <br /> Cp���J��KI{ow.t.s G�o3axl�yZ� �ll C-r�..,k (�4/`�SQaL 425-ZCn8-9�fll_ � <br /> Owner <br /> I,AailAddm59 ci� S;ace2�p Phone <br /> ITenant td���i AAdress rity Slate2iF Phcne I <br /> ��� �L� p q'7 �+ it„a�on G.�ll/480'�Z Z53'CoSI-7'r <br /> I' ��1f1.��;�{/.,(gf_IL_�1C�J-���lL!_-i.'� v� Sta;e2ip Phone <br /> ElectricalCnntractor NailAdOress �N <br /> �7 (f939 a° <br /> I ��v���O�G` Con'.��ceotbVork <br /> State 1_ir,ense IJumber n � <br /> no�,�5;M.1�ei�.i�V �GSibC�ne,t� h.�� �`�'� <br /> � � �— " Contact Person (P!an Revmvr; <br /> IPioposedUseof ina <br /> � Descripiion of Work to Be Done: � �• Y ������ �n� r �` <br /> � � � ' <br /> , ��5�w -�- - ' <br /> � ---- - � <br /> I, N07E WIRING IN NON-0WELLINGS IS RE�UIRED TO I FEE I <br /> I BE IN RACEWAYS, MC OR AC CA6LE � Q/� �J II I <br /> I CITY OF EVERETT LOCAL SALES TAX CO�E IS 7'105 'v I <br /> I Yereby ce,7i'r;thaf I have rcad and examined(his apG���ation and know the same to be Irue antl � � �— —� I <br /> correct. A!I provisions o/laws and ordinances govemmg this ypa o;wnrk u�ill bo.complefetl � �O (� I � , <br /> whelher spea(ied here�n or not. The granfiny of a perm�t does nof oresume fo give authoniy fo i <br /> Iviolate or cance!the provisions o/eny otherstafe or locallavnogula'mg constru_hon or the <br /> peAormance of construction. That 1 am authonzed 6y the o�sner oL'hrs propery to peRam Mc <br /> 'I work for whic�appGcation is mnAe and 1 compty with fhe State Contraclers La�v 78.27 RCW and <br /> 296200 WAC. � <br /> ti1AR 012013 � <br /> � -/—_L�., na,�.�e — --------ca;e ---- <br /> I <br /> I <br />