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04/30/2898 13:13 4253538934 EVERGREEN SEGYIBITY PAGE 02/02 <br /> ( <br /> ELECTRICAL PERMIT APPLICAT!nN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR 5TREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX428-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> o� 3D� ���� <br /> PROJECT ADDRESS <br /> cJ(71M�7N n os �)S-I b� �T��.� �i/1 Sl/� l,U�b 9 8'2�( <br /> ��e� Mail AtldrecB <br /> City SI�b2ip phonc <br /> Tenant Maii qddress I <br /> C�ty StAte2ip. Phone <br /> lGt�i ev� �c.�r g��S i�-roa- �'v f-- LUA- $20 3 <br /> Electri I anlrador �IAddress �� <br /> StateRip Pho� <br /> ��45 l l�-�..2— �2�� � <br /> State License Number <br /> Contred Price ot Work <br /> rrv�tl U5�Ing � � � <br /> Contad Person (Pian Revfew) <br /> Desaiption of Work to�a Done: <br /> ✓lJ� �• ��.—' � � (�� � � <br /> ��� <br /> NOTE; WIRING IN NON-�WELLINGS IS REQUIRED TO <br /> BE IN RACEWqYS, MC OR AC CA9LE, FE¢ "�,^ <br /> ���Q j <br /> CITY OF EVERETT LOCqL SALES TA%CODE IS J105 <br /> f �r <br /> !hersby ceRify thaf I have read and exemined this applicafion and know fhe seme to he hue and <br /> canec(. All provisions ollews end ordinances goveminq lhis(ype ol work w;l�/��,pmplefed Z 5 <br /> whaUier specified herein ornot. The granl;ng ol a pemuf does notp resume�o give eufhority fp � �, " O <br /> viola(e orcencel the provisions ofany other s!ete orlocallew reguleting cpnshucNon or the / ` <br /> p amence of constniction, Tl�at I am aufhoKzad Ay the owner ol fhis property fo peAonn 1he ` <br /> rk la which a Gcafion Is mude and l compry wilh 1he Sta(e Conhactors(,aw 18.27 RCW and ��Su l � "/ <br /> 2 6.200 WqC. <br /> ature � " �" � <br /> Ua�e <br />