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r <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �S`% Z— {��c�s f D r�v� <br /> PROJFCTADDRESS <br /> �� n�,�lau� GtJ��.�e.4s P�'- ��xp��Cl �ec,�,�+o�i� G�.�A g8v�13 <br /> Owner Mail Address City StetelZip Phone <br /> TBnBnI Mail Atldress Ciry StatelZip Ptrona <br /> ExGe��ftl�cfr��. YG�liPnu�Ic..A�'e. /ACi'u��. (,�1� 9b'�/08' ��34�r�oa� <br /> Elec cal Contracloi Meil Address City ShatelZip Phone <br /> ��C PE2��vo8�i 1� 9FZy7= <br /> Stale License Number Contract Price of Work <br /> x��, c���.� <br /> �e'/� S� ��- �s3 yc�s �b3� <br /> PropcSed Use of Building Conlact Persoo (Plan Feview) <br /> / ) Q <br /> DescnptionofWorktoBeDone: UPC-.'ti��C(' LC �/ S�� SLrU��`� ���� �� �� Q , / <br /> y�-� �o o i4 <br /> NOl E. WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> I <br /> Ici i r O�EVERETT LOCAL SALE5 TAX CODE IS 3105 <br /> I1 nereby certily tfraf I have read and exarrined this application and kncw fhe same lo be frue and <br /> correct. All prqvisions o/laws and ordinancns govemmg this fype o/work will be completed <br /> whe�lher specA�ed herein or noL Thv granting ol a permd does not presume fo give authonty fo <br /> vio/ate or cancel ihe provisions ol any other sfale or local law/egulafing construction or fhe <br /> pedormance o/construchon. Thal I am aulhonzed by the owner o/this property lo peAorm the <br /> work/or which application is made end 1 comply wdb fhe State Contracfors Law 1 B.27 RCW and <br /> 296200 WAC. <br /> �,G C,�. Iz�� y_i2-oG. <br /> Signature Date ���LI—�� <br /> �� r A f y Yl/ 7I� � I <br /> � t�c.-f _Ln�e�-�l�G� � /l�0 ��.`1 �ti /1���.. � a <br />