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�---- <br /> ELECTRICAL PERMIT APPLICATI(�N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX425-257-8857 -www.everettwa.org I '-0:3—�� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> G ► �( 0( � !Z <br /> ��� �i'YIG� /-�V(��(.f-Q_ L-a�� U-�CS.- �g z� l <br /> PROJECT ADDRESS <br /> !-�oa��-l� �nsc�de 3aot5vri��n (��E ��i�1t2fL�T �:b- �7�( `fZ5-Z58�58 <br /> Owner Mail Address City State/Zip Phone <br /> �Ok-\l/� L-0.,� ,J 1 _'U� 1�/ \0--1'UTA�'�J� <br /> TetlOnl Mail Ad 5 Cily Stale2ip Phone <br /> �cAcorvl Ca��i,��, �{oo� ��i��� I�c� ��,�r�l c�. 4�_zJ y�s-,3n-szs <br /> Eleclrical CoNraclor htail Hddress Clty Slale/Lp f'hone <br /> �A Cvc�94Ycb � �(.U.o `� <br /> te Lir.ense Number Contracl Price of Work <br /> Proposed Use ol Building Conlact Person (Plan Revir.�v) <br /> Desr.ription of Work la [3e Done: _ 1 fl� -FF 1���,� t.00W-t(Ul'l5�_�1�9_t��-ln��� .�[tl.�}" ... _ . <br /> �+-b[c — — -- - — <br /> NOTL: WIRING IN NON•DWELLRJGS IS REQUIR6D TO FEF <br /> BE IN RACEWnYS, MC OR AC Cnf3L6. �p <br /> 50 <br /> CITY OF EVERETT I.00AL SALES TAX COD[IS 3105 <br /> 1 hcreby cerli/y Ihat!havr,read nnAexaminr.d Ihis applir.alion ond know fhe same lo bc Iruc mid �I�f-Q� 2 <br /> correU. All provisions of Imvs and ordinances govr,mrng thrs typr, o!�rork will be cornplr.ted <br /> whefher speci�ed herei� or nof. The granfing o/a pr.nnd docs nof �rr.sume lo givu aulhrn��y(o <br /> violafe or r,ancel ihe provisions olany ofher stafr. or loci7l.��v regu�ifin9 canshucGon or Ihe <br /> peifonnance ol construcfion. That I am aulhoiiied by Uie owner ol this �roperty fo pedorm Jie <br /> �vcrk!or which applicalion is m�ide and 1 contply�vilh the Sfate Confracfors Law 1(i27 RCV✓and <br /> 296.200_ AC. <br /> •�'�__�- - �C�_�----_ --`�����- - --- - <br /> - S9naturr, )at" <br />