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�LECTRICAL PERMIT APP!LICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 S `Jb—IZ <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ���s`�7� <br /> 'S�9/9 fv����� W�ry <br /> PROJECT ADDRESS <br /> �•, .��� .�//.P1iBfi� tr-A5°Jt� G.573 /���Au �57 ��.2,a ift�r7.[d 1r�/U� <br /> Owner Mail Address Ciry - State2ip Phone <br /> Q�G �C/�1[ed2 -S�9/9 �-✓�GCr�CLL✓ 41A Y �t/t�1vT 4l��� <br /> Tenanl Maii Address City State2ip Phone <br /> �KT� <br /> j,�,�,� ���s �..,C 9v9 s �e'�`,�7 .-��a� �yo9 o2S3•�743 <br /> ElecUical CoM�ado� Mail Address City State2ip Phone <br /> �.C.t.� �r 8.3�0 77 CL�, �/Sa <br /> State License Number Contract Price of Work <br /> �S r,4�G /•L/ Q CLD.e C'dn/'�tiiL !�2/ ��E�' <br /> Proposed Use of Build'ing Contact Person (Pian Review) <br /> Description of Work to Be Done: �d� /J� ��� ���- ���� � <br /> E X/Srii.t�r J�atcJ E.e �/L�-rJ czi2n•� i�' /.S Y 8 T/�'z''�CC <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CAB�E. �� �� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 here6y certily that 1 have read and examined this application and know the same to be true and �I^� b�_��� <br /> carect. All pmvisions of laws and ordinances goveming lhis type ol work will be completed L <br /> whefherspeci(ed herein ornot. The granting of a permit does notp�asume to give authority�o <br /> violate or cancel�he provisions ol any otherstafe orlocal law regulatingpconstruction or the <br /> pe�formance o/co�CNo�n 1s mede and I cotm�ly with the St te Confrha�c(orsPLaw�8 27 RCW and <br /> wak for which app p <br /> 296.200 WAC. <br /> //� s i�� //r!= a� �Gc�f S/d •/ <br /> ���'�Signature � Date <br />