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�LF�.:TRICAL P�[�I��T A�PL_9Z�4TION <br />CIT� OF EVERETT �PERMiT SERVICES <br />3200 CEDAR STREET, EVERC•"I-1", WA 98201 ) Z. —! ��-0 � <br />425-257-8810 - FAX 425-257-8857 - w�vw.everettwa.org C� �/�� �/ <br />APPI_ICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� ' � �� �l <br />�%/� ; ;— _a <br />PROJECT ADDRES3 <br />/J � '' <br />!/�i7i: � V - C <br />Owner <br />Tenant <br />�1���,�U.�o _ <br />C-IeCtrical Conlraclor <br />^ r I�n���.i�/ s- rc�n� <br />A1ail Address � <br />��.���oUS,�,��,�o <br />State License Number <br />L��� G���n <br />Proposed Use of Building <br />Descriplian ot Work to �e Done: <br />City <br />Atail Address Cily '1 <br />A � �� <br />�s�',tis 'lnc -S/l� � � � PL /UE L /` <br />Mail Address <br />City <br />�U_ �� � �^ _ <br />�_,,,�, � �v� �� c �,.M, <br />NOTE: WIRING I�V NON-DWELLINGS IS REQUIREU 70 <br />BE IN RACEWF.YS, MC OR AC CABLE. <br />CITY OF EVERCTT LOCAL SALES Tl�: CODE IS 3105 <br />State/Zip <br />State/Zip <br />,,, /C� � <br />Sla!r.2ip <br />Phone <br />Phon^ <br />����� <br />y��'JS�',1 �}Qj1e � `l <br />l�' <br />��� � <br />Contracl Frice of Work <br />�c•� /il�o� P � <br />Conlacl Person �Plan Review) <br />1 hereby certify thaf I have read ar.d examined this app/ication and know the same to be Vue and <br />cor.�ecL All provisions ol la�vs and ordinances governin,q Ihis type oI work will be complefed <br />whefher speci6ed herein or noL The grantinc� o/a pernnt does no' presume fo give authority to <br />v:alafe or cancel (he rovisions o(any ofher sfufe orlecal la�r reguleting consfrucfion or fhe <br />peAomiance o(cons�ruction. That 1 am authonzed by the o�rner o/ fhis proparty to perform the <br />�vo�k for which applicafion is rnade and 1 cornply �ri(h thc Sfate Confractors Law 18.27 RCIN and <br />2��6200 WAC. <br />� <br />��� ��� <br />s�� �����—� <br />r-eE <br />�o b' �?-U�) <br />