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� <br /> � <br /> ELECTRICAL PERMIT APPLICAr�{+ON <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STRE[T, EYERETT,WA 98201 <br /> 425-257-E810 - FAX425-257-8857—www.evereriwa.org <br /> APPLICATIONS ARE ACCEPTED FROIA 8 AM TO 4 PM <br /> I I 61� f q�" l�rve. �� ; �Gve eef� 982oS� <br /> PROJECT ADDRESS <br /> Mi�l�a�l Wvi�V��- �e� a���ei �. ��1.��z�� <br /> OYmBr Matl Mtlress City State2ip F�fwne <br /> C�11qI�YQi I ► �Z� I 1m A� � � � 11�i�.P�P� 1Nt� 98r1?� ���>�i-I I <br /> TenaM �� y��.aYeG� �.j���Ada�ss ciry Stale2ip Pnone <br /> �v���i ���P,���r �v�o2o il�#� ��f-, hw �v�wcez� l+�A �8'L�1Z �- 3Z�-7� z7 <br /> ElectricalContrador MalAddress City Starel7ip Pnone <br /> gsa7U�5Gq��6L � ���Pl . �o <br /> State License Number Contraq Price of Work <br /> �x�td►� /duu �� <br /> Propnsecl I l.w nf Bi�i��fi c� Contact Person (Plan Review) <br /> Desc�iption of Work l0 8e Done: I/��F�GI/V (/�f I YI YJC �Vyir/ VIM ( ylDl�l ne/✓��I, <br /> _� <br /> NOTE: WIRING IN NON-OWrLLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CRY OF EVERETT LOCAL 9ALES TAX CODE IS 3105 <br /> 1 hereby ceiti(y thaf I have read and examined this upplication and krrow the snme fo be true ond <br /> correcf. All provisrons d laws and ordinnnres rlomminR fhis typo ol work will be compfefed <br /> whefher spea6etl herein or not. Thc pranhnq o7 a pennd dces notp resume to grve authonty to <br /> violate or cancel lhe provisions of any dher stale orlocal law regulatmg cunstruction or me <br /> pe�famance d constnicUon. Ttiat 1 am authomed by the ownero!Ihfs property to peAam the <br /> wurk!w�vliich applicaliwi rs nrade and 1 comply with the Stato Contrec(�rs Lnw 18.27 RCW and <br /> 2962W Ih'AC. <br /> � � <br /> ' r�� D ���c-�;� i,=i G ac� � <br /> ` Signeture Daie <br /> Ec�c( - rc� <br />