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1 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVEREiT, WA 98201 I1/.�//� <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> C iil ► �a-°�f <br /> APPLICATIONS ARE ACCEP'iED FROM 8 AM TO 4 PM <br /> %� 3a �c3,�oa�w� <br /> PROJECT ADDRESS <br /> /� }or�,on 1-{ZS &'1� - OG�� 7 <br /> 1 riu�`� �G�u`S �3 _ J , <br /> c� �,�,��� ,oa.� J,�Y�s `�1ZS— �'�/S" �tISSLI <br /> Owner Mall Addrosa Clty State/Zip Phone <br /> Tenant Mail Address City Stalerzlp Phone <br /> .L r� ^ �GH ��C.. /�'�: .�O /S� � �?n�a .,..0 G, � J U� <br /> Eleclric ConVaclof MallAddress Gly Slale/Zip Phone <br /> .��i�G�,c 9��,oy aso.u. <br /> Slate License Number Contract Prica oi Work <br /> S��P <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Doscriplion of Work lo Bo Dono: .�00/c «/ S�r'�✓-� �" � ��` '��' <br /> S'¢ra � ,� �/c v+t � Ir�el.C'1MCs ' <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. ��� <br /> CITY OF EVERETT LOCAL SALES T/ll(CODE IS .i10!i <br /> I hereby certily fhat 1 havo road and exemined this applicafion and know fhe same to be lruo end � I � � � - Z b u <br /> correcf. All provislons o//aws and ordinimces goveming this type ol woiic will be completed � <br /> whe(her speci�ed herein or noL Tho granfing o/a permd does not presume to Bive aufhonty to <br /> vlolafeorcancelihe provisionsolanyotherstafnorlocallawregulatingconstrucfionorfho <br /> peAormance oI conslructron. That 1 am 3ufhonzed 6y the owner o/fhis propeRy to perform fhe <br /> work for whrch application is mado and 1 ccmply with lho State Contractocs Law 18.27 RCW and <br /> 29G.200 WAC. <br /> 1 t� ��/019�// <br /> � SiBnaWre � uate <br />