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JUN-22-2810 19:59 From: To:2578^057 Page: 1�1 <br /> .� <br /> �� ELECTRICAL PERMiT APPLICAT'�ON <br /> ;� �tTY QF EVERETT PERMIT SERVIC�S <br /> �+_�`� 3200 C�DAR STR�ET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 �-www.everettwa.org <br /> � APPLICATEONS ARE ACCEPTED FROM S AM TO 4 PM <br /> � <br /> IC��D � � � SC <br /> pROJECY ADDt2�SS <br /> � J�.� <br /> `T <br /> D - ,� , �l��r� ��1�� - �1 � <br /> Ownor M II Address City St�te/zip Phono <br /> T�n�nl Mail Address City Stata/Zip Phbrte <br /> rG r�0 C. � t �I��OI �� ,- ('J <br /> r- <br /> �lectrical Contractor Mail Address Cfty State/zip Phono <br /> �0➢U�T P ��'��D�7 � c <br /> St3te License Number � Contract Price of ork <br /> --���'_,��o�L -� - � <br /> Proposed Uso of Building Contact Person (P3an Review) <br /> � <br /> Description of Work t0 Be Done: � � �c���� 5 <br /> c�r��''a I ;� s� <br /> �. <br /> iVOT�: WIRING 1N NON-DWELLiNC�S 15 REQUIR�D TO ��� ". <br /> BE IN RACEWAYS, MC OR AC CABLE. ; <br /> CITY O�EV�'12�'f�LOCAL SALES TAX CODE IS 3105 <br /> I herehy cenify that I have read and oxamincd this applicstion and know fl�e same to be frue and <br /> correct, All proviSions of lews and ordinance5 govemin�thls type of wor'k wlll be Completed <br /> whetherspociflad herein or nat. Trre granting of a perm�f does not pr�sume to g;ve autnorfty to � <br /> violate or cancel the provisior+s of any other sfate or local law regulatinfl construcfion or fhe <br /> performance oi consfructiar+. That 1 am authorized by fhe owner of this property ta perform the I/�l <br /> work tor which applicafion is mada and I Comply with the Sfate Contracfors Law 18.27 RCW and � � � <br /> 296.2 WA C. /� <br /> l�� U <br /> � O � <br /> iyna�ures bate - <br /> ��� �� �-�s= �-� � �a5�a� : <br /> . <br /> �� � ��� a <br /> . � <br /> �..._��_..�_..._ -.�---...__�_..._..,_..,_,__.��..._.__.. <br /> �.___.. .�-----.-��---�--�.-�...-- <br />