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_ � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR 5TREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857:—www.evereltwa.ory <br /> APPLICATIONS ARE ACCEPTED FROM 0 AM TO 4 PM <br /> ��9 �)�I sm�1'h /1Ut �tKI[�� (nail . . <br /> PROJ T ADDRESS <br /> OVmef MellAdtlress City ' Shte2lp P�one <br /> E+lu •�an Ir1�d�.,4 � ��cN,S 371°I S„„ ��. Jave �vUe�' L.� _ 9�) - H�5-a5�7a[b <br /> Ten�TT Miil AddrpGs CRy Slate/ZIO Phone <br /> /VkEr �l«�� < <LC aa�3 I5}/-��. 5 '�lG� �zµ�. r„�1 9F�39 �s3-��1-5sos <br /> El�ctripl Contraclor Mail Pddrots Cily i Stetellip Phone <br /> ,N� ��2��� 9r�i v7' �1 � y��.�� . <br /> Stale License Number Contiact Pr.ce of Work <br /> �5� S:.vav�ne.,�.. � <br /> lYlo 1 ��¢ S�ra., <br /> Propoaed •af Building , Contact P�rson (Plan Ravi�w) <br /> �escripdon ot Work lo Be Done: �!h.� a' 2 ? ' � '�"� <br /> ��;^� I I I _ � � <br /> elS M-1� .�� �innw. .v� v���.4 - <br /> NO7E� WIRING IN NON-DWELLINGS IS REQUIRED�O FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. .I�U ' � <br /> U(o : � <br /> CI7Y OF FVERETT LOCAL SALES TAX CODE IS 3705 <br /> I hereDy certiry that 1 have mad and examined this applicafion and know thc came ro be true end ��,.� �� -!��� <br /> correcf. All provfslons o/laws antl orclinances goveming this rype o/work will 6e.completetl <br /> whetner spec�fied�erein ornot. The granting ol e permrt dnes not�resume to give authonty to <br /> violata or canccl tha provision f any vther statet orfocal lew regu(eting constNctiw�or the <br /> perlo.7riance ol co strucGon. hat 1 am authorized by fhe owner ol this property to perform the <br /> �vork for which a lication i ade and 1 compty w7th the Sfate Confractors Law 18.27 RC W and <br /> 296.200 AC. <br /> b'� g-/ <br /> , - <br /> Signature Dale � <br /> { <br /> Z.i:ased L568LS2S2bS:ol 6L96ST9888 dN1:wo�� bS�bT TS02-60-9f1C <br />