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-1 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8E37-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> z3o� �,c� ��o2F�{ V� . <br /> PROJECTADDRESS y� �g Cr30 <br /> �5�.� �c (��.�,s�-_ ?3 U� 4b}� ,�� �ll E M...L,cv. `�e lJA 48290 <br /> Ownor Mail Address Gry 3tale2lp Phone <br /> Tenant�� Mell Addrea� Clty Stele?Jp phone <br /> �� <br /> �,orn; ll EI��-,,:,�,,� yor� sa s� �k sr�►�5 �.ia 98i�B �s- �6� <br /> ElecUical Conirector Mall Atltlreaa Ciy StaleZp Phone <br /> �A2N�ES �?ZaM � �` /� , �{bo <br /> State Ucense Number Con ct Pdce of Woric <br /> Q.tS�d.t...�� r lu���f.itrn��N/1 �� �j�(J Jas nw �G, ►O _ <br /> Proposed Use oi Building ` ConleH Peroon (Plan Review) <br /> Description of Work lo Bo Dana: _y,►_,__rL ��a� ��� ��� '��/Gk <br /> -f <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 3105 <br /> 1 horoby certlty thaf I have rood end examined thls eppl/cedon end know the same to be true end <br /> coRect. All provlslons of laws end ordlnances goveming thls type ol work wil!6o complefed <br /> whefher speclfled hereln or not. Tho grantl��g oI a pormlt does nof prasume to glve authortry to <br /> violafe or cancel(ho provfslons of any othar stete or locel lew regulaf/ng constructlon or the <br /> peiformanco o/cons�ructicn. Thef 1 em aufhorized by fhe owner o/this property fo perform fhe <br /> walc!cr whlch appllcetlon Is mede and I comply with the Slate Contracfors Law 18.27 RCW and <br /> 296.200 WAC. //,;j <br />, �//_ V. <br /> Sipnaturo Oate <br /> conrr.on�j �INd,�'rl'19 "1'IeINNYA 0£BGSC£S7.t ]N;1 L0�6I L007/OC/li <br />