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�.� i� <br /> V <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EUERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETf, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ��n2s 19 +'^ �Le 5� s��+e a�1o� _ <br /> PROJECTADDRESS <br /> J�.�be,�.k 1�.�.� iools Iq� Ave Cyea.��+ wr� Rsa.oSl �ts�-r�-►-�4 <br /> Ownet Mail Address Gty State2ip Phone <br /> 5�,,.�, DLN�.1 io4aS" I'�i'�^ f�V� Eveect�!- w�+ 9ywr `C'�S3Y-�z ,S <br /> Tenant Mail Address City State2ip Phone <br /> R�� P, d , ��x � �i�. ��n.wTu�i►= w A- 9���0 3�o-Ls9- i3� <br /> Eleclrical Contraclor Mail Address City State/Zip Phone <br /> _ZSe,�E 'r012 Q2. I()� OnU <br /> Stale License Number Centract Prico of Work <br /> De,N �v�e �,1� u �� Ce.�5 3ea.�. �.�,S <br /> Proposed Use of Building CoNact Person (Plan Review) <br /> Descriplion o(Work lo�e Done: N e.� �� 'k'�^' � P�`Ne�- W � AIC�.I 11��.� �N'� <br /> 0.N0 '���ci�- <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 certi(y fhaf 1 have read and exnmined fhis applicalion and know the same to be(ruo and <br /> conec(. A/l provisions o(/aws and ordinances c�oveming this typo of work will be completed <br /> whefher specihed herein or naL The c�ranting ol��permd does not prosume fe give authonty to <br /> violafe or cancel the provisions olany otlier state orlocalla�v regulating construction orthe <br /> perfomiance o(construcfion. That 1 am authonzed by fhe o�vner o/fhis property[o perfonn the <br /> �vak for which application is made and I comply with tho Slafe Contractors Law 18.27 RCW and <br /> 29G.200 VI�AC. <br /> �M MNV � 4J�{�.� � ' �s�' � � <br /> � / <br /> nelure Dato � �j � <br /> � <br />