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l <br /> ELECTRICAL PERMIT APPLICATIOf� <br /> CITY OF EVERETT PERMIT 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 /> + , � ' } l_' �� c_ ✓C � :\�L. <br /> PROJECTADDRESS l75 ZS `I U'iGc� <br /> `:� iN� E: �� S �� �-I�tDZ ,.iL' 17 , � L,.,cL�i–(� A�` iCUcZL%'r �..i� `l�lvl <br /> Owner Mall Adtlress City Slate/ZiD Phone <br /> ;�,�� ns ,�1�., �:- — <br /> Tenant Mail Atltlress Ciry State2p Phone <br /> �� ��� <br /> �_Atii `! �-l�n�� Z � •-� �L 'IJ7( .l�� iaHCO i�Vc. IV�nTC ��Y1� LAr�' �.ii✓ ')7/lU I� ZG�4fil7 <br /> Electrical CJniracto� Mail Address City StatelZip Phone <br /> State License Number Contract Price of Work <br /> {�L�I l>�_sUi_� – tt�-r"��S 7��4� — <br /> Proposed Use of�wlding Contact Person (Plan Review) <br /> :� - �a�r' fa�' A�1�� -iu.i • �J <br /> Description of Work to Be Done: � <br /> �� i ('� A+vO A90i�fc�r���L � iC'c�.,'r7 �u� M/l (Jt-v p� .—� o,..i ��U <br /> i ��r ��;'� G �rr hZ ��a X /15 !� Su 13 � ���C1� � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 9105 <br /> 1 herehy certily fhat I have read and exanuned fhis applicafion and kno�v the same fo be frue anJ <br /> correcL All provisions o/laws and oidinances gavernmg fhis type ol�vork will be compieted <br /> �vhefher speci6ed herein or not. The granting o/a pennd does nof presurne to grve authonly to <br /> violate or cancel fhe provisions ol any o(her s(afe or focal lau�regulahng constniction or the <br /> pe�forrnance olconstrucfion. Thaf!am authonzed by the on�ner o(th�s properTy to perfoim the <br /> �vork Ior�vhich apphr,a(ion is m�de aqd I cornqJy�vdh fhe Stafe Contractors La�v 78 27 RC W and <br /> 296.20D'LVAC. , . . � <br /> ( ; � �,;� �� �'� ; ,- <br /> � � �„i� , �.�, ' {'� (G� ll - Q 7 � � - fi <br /> Signature .,�� " Dale '� <br />