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1 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PE�MIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> I rj oo h�2sr Sr2cci, rn�r,�-Ko �.Jq, q $2 �5 <br /> PROJECT ADDRESS <br /> C�1 L>� <br /> {�o2T o�- Cv�2�-�y- P.o . (jox 7 38 Gvc'2c� W/} . 48ZoG Ztiq- 3(6.4 <br /> Owner Mail Addiess City ��ate2ip Phone <br /> CSA+�e ns Flr3o�E) <br /> Tenanl MailAddress City Slate2ip Phone <br /> 1�A��V Eic�-Tci�c C� _ 3j1� 13z"'� S"i. S-u _��f L`Ct/�uuoo0 �A `i�u4� l <br /> EleClriCal ConiraC�or Mail Atltlress Ciry Slate/Zip Phone <br /> �{ZS- 7SZ -l$Z(o <br /> OA�To E�- o-�TKL � S�riO�, Z � � <br /> Statr. License Number CoNract Price ot Work <br /> l,�V��oAO Q 'aR4c YY�/iTc'2�A�-� QA�L Cq(ZS ��S m� e� e <br /> Proposed Use of 8uilding Ooc.k Contacl Person (Plan Review) <br /> .� <br /> Descnption of Work to Be Done: NEI.J D OG K 'Co $y`A Po(Z� Q A 2�E To <br /> 2A��- ca��2" Oc'��ve��es Fe2 3oEwc� cvmpA,lY <br /> 1�2.� vtdc' ,VEt.,.1 $E2v«c' t=o�L LI�N-Tw4 A-n�0 <br /> L (�qVc POc.JQ � , <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. � �� 3 �r . r� <br /> GTY OF EVERETI'LOCAL SALES TAX CODE IS 3105 <br /> I I hereby ceriily that 1 have n:nd and exmnined this applicnfion and know the snme lo be fine and <br /> correcL All pmvisions ol lnws mid ordinances governmg Ih�s type o/work will be compleled <br /> whetber speciGed herein or noL The granling oI a pernut does nol �nsurne fo 9ive aulhonty lo <br /> violnte or canr.el�he pmvisions al any other state or local law mguPfing cons(n�cfion or lhe <br /> pedomiance o/consf�uchon. Thal 1 nm aufho�izcd by the owner oI(his property to pedomi the <br /> work Ior wbich applicn(ion is rnnde nnd 1 comply wifh Ihe Sfnfe Conlrxclors Law 18.27 RCW and <br /> 296200 WAC. <br /> � !o zo o s <br /> Signat ire � Date / <br /> / <br /> `_��, -� .� 7 <br />