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m:MyFaz-Josh Tokarsyck (14252576857) 11:21 01/17/71GMT-05 Pg 01-01 <br /> � � <br />�� <br /> � EL�CTRICAL PERMIT APPLICATION � <br /> CITY OF EVERETT PERMIT SERVICES ' <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org /_ �D,_�� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ��/O/ ,,,��7 <br /> 6�00 23� �,�ve j�J e st EJe:e t+, w.Q �t tsz.�.:3 <br /> PROJECT ADDRESS <br /> yYiL ^�E `i7^" <br /> ,U;Z nit� l�c� i�76R �eaw�ti �"+ `l�► GL� �ti�,1�1� r,,;R `�51(S yL5'�i.o-bGo7 <br /> O.vner MoilA dress Ciy Slale/Zip Phone <br /> � <br /> 1Cac�� 2727 Wrsatn ia.. �2vo S�ctNli (.i�A 4YIZ1 zcL•-•`53F..- 2s.c; <br /> Tenant Mail Aodress Cily SlatelZip P�one <br /> -�hx /nky-�:'K�' � � zZ�t�4. •a�:�Avc SE �ktaA\ jtl.� 9�1��21 ZcC•35�Z�ct <br /> T°-an �� ts �m �c � - <br /> Electrical Co lractor ldall Atltlress City State/Zip Phone <br /> r <br /> � TEC� ��l-�t3Zl. l y� 1� 9 <br /> State License Number Contract Price of Work <br /> �nKnou.;/� <br /> T�,a T�Kurs.. .t�- <br /> Proposed Use of Building Contact Person �Plan Review) <br /> Description of Work to Be Done: �ti9���a'f'•� '1 v 6' �Z�1� �hr� L'u��S fU Ac oJ <br /> �� � <br /> NO'fE: INIRING IN NON-DWELLINGS IS R[QUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES 7AX CODE IS 5105 <br /> I hereby certily that I have read and examined this application and know the same tn be true and �� I U� _ v�� <br /> r.orrecG All provisions o/la�ss and ordmances govemmg fhis typo o/work will be completed <br /> whetber specdied herorn or noL The granlinq o�a pennd cloes nuf re5ume to givo authe��ty fo <br /> violafo or cancol lho�rowsians o/any o�her stafe or iocal law ieguP(�ng consfmchon vr lhe <br /> perlo�mance ol construcfion. Thot I am authorized by the owner o/fhis propeny ro poAonn fhe <br /> work Ior which application is rtiade�ntl 1 compty with the S(a�e Contractors Law 18.27 RCW and <br /> 296200 l?(AC. <br /> l; <br /> / 'ci�'.�e'`� �- �� -'ZC: � � <br /> � Signalur Data <br /> � <br /> � <br />