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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.evereV00YD.Fi�g <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 2211 W � C (�Sin� Qr��� <br /> PROJECT ADDRESS <br /> ��fr� �lake, �U 1U�I V`-1� �PI � � � 1���)1�1� c 0 ,�� �1 �1�2�5 2��-�is- I ob <br /> Owner MadAtldress Qty Slate�vAp Phone <br /> `�h � S��Kr v�o�o 2211 W casirlo Ev�,�e}}�1�A °Ig20� _ <br /> Tenan� MadAtldress CAy StateMlO P�one <br /> Cqvv�rn�rc t�l :111�t� r�•� ck� c i���n 1� ���x 1'l� �II, UQ►���o��.l�J�t �ib �� <br /> EleclriCal Contrac�or ManAdOress Crty StateN.iD Phone <br /> CCMMc ►��-��I�� .O � I , �lle(1 .�' — <br /> State License Number Contracl Price of 1Nork <br /> �1(�rl {�uv�Z �I�O-�(N�6'I 3�i <br /> Proposed r se of E3uilding Contact Person (Plan ReviewF <br /> Description of Woih fn Pe Dnnr, � ����� � � <br /> '- l}- ��;t `�t ! Q�11 <br /> �{, �� �� i�`� c�� �hr � C�la� � ��ntr c ��i �ti, <br /> NOTE WIRING IN NON-DWELLINGS IS REOr IRED TO FEE <br /> 8[ IN RACEWAv S, MC OR AC CABLE <br /> CITY OF EVERETT LOCAL SALES TAX CODF IS 9105 ra�7�(/_/n C� <br /> I heieGy cerfily thnt�havr. read and erarninr.d fhis epplication nnAkno�r fhe sarne ro be huc end C I O K� � <br /> correr.t. All prnvisio��s olla�vs nnAordmances,qovemirig this type nl�:�ork will be conrpleled <br /> whefher sper.ilied he�em arnot The granfrnp o/a pernut doe:�not presume(a give authority tc <br /> violate o�c��ncel thr prvvisions o!any nfhe� stafe or Inr.al lau�regulabnq consfrachon or fhe <br /> pedorninrico nl�;onsGucfion Thaf I am a�dhonzed by t'�e ouvror o/fhrs proporty to per/om� the <br /> m�ork lor�rhrch�ipph.:afron is maJe��rid 1 coniply n�ith flre S�afr. Conhacfois La�v fA 2i RCW nnd <br /> 296 200 W�C <br /> L, - C_ c���IIT�, <br /> ,-. 1,�t i <br /> ti�natme �� <br />