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�- -- - - �-----�--- - -C-- -- - '� -- --- � -- -- -� <br /> -- - -- '� � - - -- - <br /> � � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVEREfT, WA 98201 <br /> 425 257-8810 - FAX 475-257-8857 —vuww.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 13�c7 i�ac,i.�rc. Ave�L� <br /> PROJECT ADDRESS <br /> `�Q.G�F�c. � l�l�.ri� `y.'Q� ."1�� ��dr1 H�cd� �2�'Z�i a � <br /> OwnCr A'atl ACom.c Clry 51ate21p Phonx <br /> �mes�� � V� �I�nC�. <br /> Tenact hta�l AdEress C��ty StomZp Ptione <br /> � rt S �l Ol �v?•rC�{�.JA q$L6��'���8• O <br /> Eleqn�3'�� Ont�aC,c� M1to tlress G� State2lp Pnone <br /> L�v�2�ss i �a�a; 3'f0•� <br /> S�� Lia:nse kum�er Ccntraa Pnce ot Work <br /> (��mm P.�-c,�o..S� ��ru.V l Pll u r�-�� <br /> Proposed Use cf euddiny Cantoc;Per3on (Plan Revicw) <br /> Descnption of Work ta Be DqPe. ���/�� I �"��� ' "' Wv�� v I <br /> ���� r�l� �0..�'1.1� C_ VJW4'�l�✓1.C . <br /> NOT[: WIRING IN NON-UWELLINGS IS RE�UIRFO TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> �D o0 <br /> CITY OF CVGRETT LOCAL SALCS TAX CODE IS 1105 � <br /> 1 hereby certAy Ihaf IOave mad and oXamined Ihis appbcahon antl kno�v U�a same tn Ae frva and � I ��O 3� I � <br /> cunvct All pmvls�ans ol lnws and orclinances goveminp tOls tyPo of work wdl be,cump.'etod � y <br /> «�^erther specified herrom p�not The g2nfin�o!a permd does nul ptesume(o grve Buthority fo <br /> vrolare o�conccl fhe provis�ons of eny olher stete or locaf/aw regu/a6ny cvnstruclion o�(hu <br /> perfornnnn�of cronstmchon. Thnt I nm eu(honzed Dy tho ownor of fh�s propeRy to peAorm fho <br /> �rork fo.�vhrch apphc,Gon is madn and I Comply wifh fhe Siefe ConVscfors Lx�v 1 B 27 RCW and <br /> 296.200 WAC. <br /> ?� ���1 �� <br /> S�gnwtTe Oam <br />