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( <br /> ELECTRICAL PERIVIIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8657-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 2�Q �0 1/1� ��'vl-��r'�i ,4���P� <br /> PROJECTADDRE33 �ys 2� � <br /> ��� <br /> 2�( .nl, (.e C'o,�,c-k 73D7 46f�`�.,� nJ.�-- I►�Q,�rrv,�l�? L�,#� j47,7b <br /> Owner Mail Addresa � Gy SlatelLp phorre <br /> �� <br /> Ton t Mail Address Gty gface/Zip ��s�q� <br /> r� <br /> U.atiuFu� FL��fn_iG DUG '!b/S' S�2.tL lk ST'�l,�l/.f' 6✓A 9�-�� <br /> Electrical Cqntrecto� Mall Addresa Gry State/Zlp Phww <br /> �(A�uE�r 97 8�t � vb <br /> Stato Liconsa Number Contrec Pdce of Work <br /> p��:d�w-�:�� M�.�k;�'�,�,.� .���� ;�.so,� �.4.n � <br /> Proposed Use o1 Bullding Contact Person (Plan ReWew) <br /> DescripUon of Work to De Dono: �vt.r��Q.ct,� L�Q.WL(� �p�y�QY' Pn) �_ <br /> � D <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 /> I hersby ceAily thaf 1 have road end examined this applicatlon end know the same to be true end <br /> cormct. All provlslons o/laws and orttinances goveming thls typa ol work wlll be completed ' <br /> whefher specilied heroln or nof. 71�e granting ol n pormtt does not presume to plve euthority fo <br /> violato ur cencel fhe pmvlslons olany other sfafe or locellaw regulaUng consWcUon or fhe <br /> perlormance ol constnrctlon. Thet 1 em euthorized by fhe owner of thls property to peAorm fhe <br /> woifr lor whlch appllca0on Is mado ond 1 comply wlth the Stafe Contrscfors Law 1827 RCN and <br /> 296.2 WAC. <br /> 2�° �l�"1�.,� <br /> gnaNre Dale <br /> C00/7�00� �INd,�'rl"18 "1'IiIN21k',1 OE6L5CCSi.b Xt'd LO�FI L007./OC/I1 <br />