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P1AY- 13-2G�JJ 12 :25 PIQ EEC 120n74349:'",• P- rj� <br /> ELECTRICAL PERMIT APPLIGATION <br /> CITY OF EVERETT PERMIT SERVICES s_i3,�.,� <br /> 32U0 CEDAR STREET, EVERETT, WA 9820 i <br /> 425-257-8810 - FAX425-257-8857 —www.evereStw�.org � O��S v7Z <br /> APpLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �Pa r�- Eu�r�:i-I- Ma-r�i�c� <br /> �-;I�I- 13�"�1� _.. <br /> PROJECTADDRESS <br /> ��rT � �VPrC�'� Po gO�L 5; � ��2�'�" �/V� Q8�(n <br /> OWrlor Mnll Addross Clry Slela2ip Phona <br /> Tonanl Idoil Addwss Gry SlelelZlp Phono <br /> �I��-I,-�r� I �-�r�� � �hrr4rarh>r �P�` 1� �� 1412h hl� I I Cr��__� i��a <br /> Eloctricnl ConUeclor 1a11 Addross Ciry SIaro21p P�ona <br /> �+2s-y�i-�ac�o <br /> E L�CT�C-�.�o S� <br /> State Licnnso Number Contract Price of Work <br /> �1.��11�� ``.7�'CC�"iOfl � ,nr » nnrr�� -- <br /> Proposed Use of Building Conlsct Ferwn (Plon Rovlew) <br /> �� 25-�tSI-SZ�O <br /> Description of Work to Bo Dono�. � ��1 — <br /> �J�l�.��_111.f.Z�- ��'1�uPr I]� ('7�El�l'�� <br /> NOTE' WIRING IN NON-DWELLINGS IS RE�l11RED TO FEE <br /> DF_ IN RACEWAYS, MC OR AC CABLE � <br /> CITY OF EVERETT LOCAL SALE3 TAX CODE IS 3105 `� 5- ��'� '� ' <br /> 1 horoby cedi(y fhet I heve reed end oxem�nedthis oppliwfion end know the same fo be fruo and `_V-' O v <br /> corroct. All p�ovisions ollews t+nd ordinencos govemntg fhis typo ol�rork will be completed <br />,I �viiofhnr spec�Fod horoin or not 7he gren6ng o!e pemut does nol prasume to give nuthonly to <br /> violafo or cencel lhe Prowsions ol er�y olher stnfe or local ler�reyulafing consVucfion or the <br /> �orfarmnnce a!consliuction. Thef 1 xm euthoiized by fhe owner ol thrs property fo perfonn the <br /> wa:k lur which epplicn(ion is mnde end 1 compfy�vith fhe Sfnfe Confrncrors Law 1 B 27 RCW end <br /> 296.20 AC <br /> �T,LI'.�ifi( (�t/ �['/1/1��1.L�1 I.� "111Ci� � Oq <br />�III SlpnaNro Date <br /> I <br />