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� <br /> ELEGTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SE�tVICES <br /> 3200 CEDAR STREtT, EVERETT,WA J8201 <br /> 425-257-8810 - FAX 425-257-6857—www.everethva.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � � Z2. 1 �( �.✓`IL ( /�1-aLtz 12JA�� <br /> PROJECT ADDRESS <br /> Gr o�= F - - <br /> Owner Mail Address Gty Stale/Zip Phone <br /> F,HL s-���--� �� <br /> Tenenl Mail Address City SWtelLp Phone <br /> Ows�r(� <br /> Electrical ConVactor Mail Address Clty Stale2lp Phone <br /> _ - /� �`- <br /> � v�t�. �c'rG� `7UU <br /> State License Number Contract Pdce of Work \ <br /> f�H e�� ��nt-�.�J . � <br /> �2C 7S Td�/�_ <br /> Proposed Use of Bullding Contad Person (Plan Review) <br /> Descriplion of Work lo Be Done: rnv��. ��-- �k 1-YTS �n7 Z S�� �'x-�tE 1 - <br /> / <br /> /�iT-� F",-�� C aC�51c . � �tnr117�v �' , 5.�m� Liy/+�� <br /> SG•�/ <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO �E <br /> BE IN RACEWAYS, MC OR AC CABLE. ��5 U <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 t /� <br /> 1 hereby certify thaf I have read and examined fhis appllcation end know the same fo 6e true and L � ZvL —07Z <br /> cortect. All provisfons o(/aws and ordlnances goveming thls type of work will6e complofed <br /> whefher specified herein or not. The granting of a permif does noi presume to glve authority fo <br /> viola(e or cancel(he provfsions o(any other state orlocallaw reguleGng consfruction or the <br /> perfom�ance o/consiruction. 'rhef 1 am authorized 6y fhe oK�ner o(fhls property fo perlorm the <br /> work lor which applicafion is mado and 1 comply with fhe State Confrec(ors Law f8.27 RCW end <br /> 296.200 WAC. <br /> V�'� 2� I(�' f z <br /> Signature Date <br /> ��IA-y�_ �'�"�,ns�z=.�J <br /> � . <br />