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ELECTRIC�L PERMIT APPLICATION <br /> CITY OF EVE?ETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM I a 'a� `ro <br /> ���/ 2-��� <br /> (� a,� o13r� nr, �„/ Sfc /03 <br /> PROJECT ADDRESS <br /> Se�L� f </i9 L �� �/`/ �� cs� St� S�.fll� l,./I �18YOS <br /> OWner Mail AdJress City Slate/Zip Phone <br /> ��'����P�� �iY�o� c'frccf'� �oZ,f7D a.3�oC l.�r l✓ S' fe /<i 3 �"t <br /> Tenanl Mail Address City Slale/Zip Phone 9 <br /> FliPri�rivn Il T/'i � �a.T� �7n 7�7 S �rM va� $'f .SGr��� �n//9 �i�/�� <br /> EleCtriCa onlrac�or Mail Address Ciry Slate/Zip Phone <br /> F V F_ R lrR 1. 9 I S L !i 5��, o� <br /> S�ate License Number Conlracl Price of Work <br /> imian �e ���ia,� <br /> Proposed Use of Building Contact Person (Plan eview) <br /> ao6 - 76a ����rykay7 <br /> Descrip�ion of Work lo Be Done: /�/J e �,L,� ��1P/'mOS�U,� _ <br /> NOTE: WIRING IN NON•DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify that 1 have read and examined this application and hnow fhe same to be hue and <br /> correcl. All provis�ons of laws and ordinances governiny this type ol work will be completed f�I (�� 2 � �� <br /> whether speafied herein or noL The granting ol a permit does not presume to give authonty(o <br /> violafeorcancellhe provisionsolanyothers(ateorincallawregulafingconshucfionorthe <br /> per�ormance ol construc(ioa That 1 am aulhorized by the owner ol this property to perlorm the <br /> work lor which applicafion is made and I compty with fhe Slafe Conlraators Law 1827 RCW and <br /> 296.200 WAC. <br /> ����L/it, i?�%2/i,l�'�/J7l _ �ot�/l / � D <br /> Siynature Date <br />