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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERM17 SERVIC�S <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —wv✓w.everettwa.org <br /> ,'�PPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br /> fo333 , �� a� st F��.-�.-�-, w� a� ��g <br /> PROJECT ADDRESS <br /> � rn.p ��c P.O. 6ox �zosri w���1 C,-�.e,k wA ��08 2 �"/� <br /> Owner ldailAddress Ciry State/Zip Phane <br /> N W Asd'�rh0. S � <br /> Alle�c�a 1 �333 19 � Au� SC: Fvcret}' �''p. 9c6'�O ^�l� <br /> Tenan� Mail Addrzss Ciry State/Zip Phonc <br /> , �"I/ "1 D t,�'ra i�' � v e S W (�o G� <br /> w.�.�O�r�..��. �.t�;r S-��..�t- D � a �uio� �c�� - y�.�� <br /> ElectricalContractor M.3ilAddress Ciry ��ate2ip Phone <br /> y�n�4c boM� 9�l1- � F 1 llo/0 9 � � � 3 0 . (S� <br /> State License Number Conlracl�rk <br /> � � ✓hM-Q.f C 1 c..� SC-' S.$ C' Y Y `b v�� Z. <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work lo Be Done: � �lR.W �� 5`�� Q+'�r� � �-�-`-� �x��� $� �'� <br /> �o,.,v� �r�Z�IL'Gk - AJI Lbl,u V oI�4Q 2. <br /> NOTE: WIRING !N NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE iS J105 <br /> I hereby certi/y thaf I have read and ezamined this appli�ation and know fhe same to 6e true and <br /> correcl. All provis�ons o/laws and erdinances goveming Ihis fype o(work will be completed <br /> �vhefher specilied he�ein or noL The gran6ng ol a permd does nof presume fo give authority fo <br /> violafe or cancel fhe provisions ol any other stafe or local law regulating consfrucfion or fhe <br /> pedormance oI consVucfion. Thaf I am authonzed by fhe owner ol this property to pedonn the <br /> �vork(or which application is made and 1 compty�vilh tho Sfafe Confracfors Law 18.27 RCW and <br /> 296200 V,'AC. <br /> � ._ _� �i���� IU — I1 - �7 <br /> ____�gnet re Date <br /> j� u"I r0 G56 <br />