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ELECTRICAL'r'ERMIT APPLICATiON <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — �wdw.everettwa.org <br />APPLICATIONS ARE ACCEPTED FR0�1 8 AM TO 4 PM <br />�Y�S% ��%�i/iJi/a �vC:� <br />PROJECT ADDRESS <br />��C.-I-{�/� (� <br />Owner <br />Tenant <br />Eleclrical Contrac�or <br />Mail Address <br />A1ail AdOress <br />�rYL�G.2n�C tG I Z <br />Mail Address <br />W ���e �✓Fs �I `-1 o L'l <br />S�ale License Number <br />! l� v�J i I/\ �. <br />d Use of 6uilding <br />,� <br />Cily <br />V� <br />Slale/Zip <br />City Slale/Zip <br />.TU/1r.1 _�100�7 Wfi�L1 �� <br />��a-�7 <br />C-o �o a �053 <br />Phone <br />Phone <br />I/JY�1 <br />City State/Zip Pbone <br />`�9�i( <br />� `7 Oo °= <br />Contract Price o( Work <br />Contad Person (Plan Review) <br />Descriplion of Work to 6c Done: �- N��� �� � S%�7 a IC i� �i C-7�C7-0 iQ 5 //� J 3�7%%� � ��7 S%�y �) <br />��1% P.�;:-� DUV�.J I-iA«-S, —LNSi}1�L LIE,N"� Ar'� FAN�LiC,H1'Cd��76o <br />/1��'�9 C,l���- r�� ;���T�-I E-,�or�-1 ,/�L� Worci� oN �X�STiN� Cr/�CviTS, <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED r0 <br />BE IN RACEWAYS, MC OR AC CABLE. <br />I CITY OF EVERETT LOCAI SALES TAX CODE IS 3105 <br />1 here6y ceriify ihat ! have read and esamined this application nnd know fhe same fo be true and <br />correct. All provisions ol/a�vs and orAinanr.es govemu�� this type oI �+�ork �vill be completed <br />whether specdied herein or not The granfing o/ a permd Aoes no( presume to gi��e authonty fo <br />viola(e or cance/ Ihe provisions ol any olher sfate or local lmv regu/ating consfrucfion or the <br />performance o/ consiruclion. That 1 arn aufhorized by the owner o/ fhis property fo peAe�m fhe <br />work lor wh�cl� applicntion is made and 1 comply �rifh the Stafe Confractors La�v f 8.D RCW and <br />79G.200 WAC. + <br />i� <br />/;� � �� j ± .--� '� q <br />_.-�n ,���%'�'`�/'���! `-- I — (� 7 <br />c , <br />� �� !.0 ' Zlt <br />Sir�ualwc DOIe <br />FEE <br />Evlo � -c��,3 <br />