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( � <br /> ELECTRICAL PERMIT A�PLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 C ��`0� <br /> 425-257-8810 - FAX 425-257-8857-www.everetlwa.org b���_a�Z <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ZoOo lLe.w�tt' 'Ar� S-�'e:�F 2csU Evei'cl�, �,..)A rt$2l3 <br /> PROJECT ADDRESS <br /> 2 ot�u 41e�,.:1�' A�.,, Si�-1t ZcSa <br /> �vtr� vev�} (.�}ie F�.vrc-�F w� �tS(�l3 4is-ZS-1-�'O <br /> Ownar Mail Adtlress City StatNZfp Phone <br /> �G. � I.VGr��" �►�l 2 Z(7b0 {�W..i�I �µ�, �'�� �Ve���w� �1S(l�3 c2�-SY60 <br /> Tenent Mall Address Ciry Slate/Zip Fhone <br /> 20d- <br /> nno,�.�D�..�l�. m.�l,w -n�, ot+.�,� r+,,,..s �� k�.ytl., . ,A 4a��. -,��•�la�g <br /> Electrical Contractor Meil Address City Slete2ip Fhooe <br /> nn�C,oumf- �1'�- gF I�l./o9 � l �`�`1 "" <br /> State License Number Contrad Price of Worlc <br /> C`Uvr.✓r-4s�Cc�` IM�k.t ►N�l.��Ive✓'n <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Descriplion o(Work to Be Done: (i14,0 C�Y)✓1 D(� �,yC\S�"1 Y1 O g0..5 �� �� C,✓ .-a ti� _ <br /> fv �ro.v�o r�' � /Ut.W JCI,p �•,••,lo�c^ _ � wc U\ 1' c +�l? <br /> \v�S�xa �� 1 SI'��+.�' 0 <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABIE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 here6y certily fhat I have read and examined fhis application and know Ihe same to be frue and <br /> conect. All provisions ollaws and ordinances goveming this type ol work will be completed <br /> whefher specilied herein or nof. The grenting o(a permif does not presume to give authorify to <br /> viofate or cancel fhe provisions ol any other state or Incal law regulafing construction ar the <br /> peAormance o/construchon. That 1 am authorized 6y the owner o(this property to paAorm the <br /> work lor which application is made and 1 comply wifh fhe State Conlracfors Law 1827 RCW and <br /> 296.200 WAC. <br /> �- � - oY � 2'� . <br /> �fe Date ��l <br /> i��l <br /> i <br />