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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 —�,��7..p7 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org � 07o7v�D� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �"�0�7 'S'-14fLUN 1�2. <br /> PROJECT ADDRESS <br /> �A t� 'µ(n <br /> Vv IJ Y 2�ftn Sca.� 1��5r. <br /> Owner Pdail Address Cdy Slate/Zip Phone <br /> Tenan; Mail�ddress City SlatelZip Phone <br /> JJ�As� SiTtEE� �l-�cc P.o. 3uF �l3stv t�DrnnN�•� v�v. l99020 'L-t2�7�S�z <br /> Eleclrical Conlraclor 6fail Address City State2ip Phone <br /> �M+4z�+ SG�2oL���L p2 SD� <br /> S�ate License Number Conlract Price of Vdork <br /> //D�L �y+iL� <br /> Proposed Use o(Ouilding Contact Person (Plan Review) <br /> Description of Work lo�c Donc: �4'P�� Co�+,�u=T �`�Ky57'Zni�.\ � 3KS��41.L- <br /> � SV2FA-Lri �'LJIZ, VTS • <br /> tJOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SAL� �TAX CODE IS 9105 <br /> I hemby certily fhaf 1 have read and examined this application and kno�r fhe snme to be frue and <br /> correcf. All piavisions olla�rs and orAinances govemmg fHis type o�wo�M�aill Ue compleled <br /> wheUre�specilied herein er noL The c�ranling ol a pennd Aoes nof xesmne fo give.authonty to <br /> violaie or cmicel fhe r�rovisions oI mry ofl�er sfafe or local lmv regu�iting consfrucfion or fho � <br /> �BIIO/111811CC OI CO/15fruchon. Thaf 1 am aufhorized Gy(he on�ner ol fhis property lo Perlorm Ihe /�, <br /> �voik Ior�rhich applicafion is maAe and I coniply�rilli fhe Sfate Conf�acfors La�v 7827 RCW and ,� _] ��7�� — � `� <br /> 29G.200 Ih�AC. <br /> ��"—" l � ' l� - O � <br /> anaturc ° Date <br /> ����� ��C�� <br />