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04/07/201( IEi:20 I�AS 4'253357830 �'ARNGLL GLGC1'RIC C�JOUJ/00� <br /> � i <br /> E�ECTRICAL PERMI`T APPLICATIdN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETi, WA 98201 <br /> 425-257-88i 0 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �� _� �� <br /> r' ;r.�[!- C `� / <br /> — , �. , <br /> � 90(0 .��7� D2ivE �'.E. �o i� � ' <br /> PROJECT ADDRESS <br /> �c�0 4�4 5 I 6 I <br /> 1=n P�E �,n„� �fy�ic-r . a�� (3nk 130L� M.�i2YCV/�LE \.✓,4 . i,�L�n <br /> Owner Mail Address Ciry Stalo2lD Phonu <br /> SArnE G.S .4li0✓rc . <br /> Tenant Mell Address Clly Slate2ip Fhono <br /> c�7,s 33S 7600 <br /> vA.wc �-L ELC-LT�-fG � �� y0/r „p� y2 LA4F CT .���.�/S \nfa T.YZcI; <br /> E-Ioctrieal Conlraclor Mall Address Cfty Sfata2lp Phone <br /> Vk a...c!�E _ �i 7 f3 M P� ' �' L�� 3 5ct 0 0 <br /> State License Number Contract n''�Work <br /> S: rG 1 t �'a,.�� �Y 2���. <br /> Propos�Use of Bulidfng Contact Person (Plan Review) <br /> Descriptlon of Work to Be Done: `�/ ; ,2 E �I�O g� �i �� �'��� �A N�i �`� YJ�.� , <br /> ��� W ( nnG-(�n , , ct� bl�J <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 /> 1 hereby certl(y thaf 1 have road and exam(ned this app!lcatlon end know the same to be We and <br /> correcl. All provlslons oflaws and ordlnances govoming thls type of worlr will be completed <br /> whether specllled herein or not. The gronting o/a permi!does not presume to give euthority to <br /> violate or cancel fhe provfsions of ony oGher state or locel law reguleting conshucdon or ihe <br /> perlormance o/constn.�cfion. That!am authorized by the owner ol ihis Froperty fo per(orm tha <br /> work/or wh/ch appfication!s ma and 1 comply with the Sfate Contractors Law i8.27 RCW and <br /> 296.2 WAC. <br /> - Z � <br /> 7 b �� <br /> Slgnature Date <br />