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ELECTRICAL PERMIT APPLICATION <br /> CITY '�F 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 /> Z� � li'\' ',�.�'�) �� �'1:.. �U f•t <br /> Z� <br /> PROJECT ADDRC:SS <br /> 1LS.S�`1���L�� IVti (Yli' F-�.�� C�a'�iE� �.;lt,..� / iveR.�ir �✓� ��C.�)C��) _ <br /> Owner MailAddrrss C0y Slate2ip Phone <br /> Tenent Mail Address CNy Slete/7.ip Phone <br /> i_74 �1' AJ� S �F A�t�,S ..�+p `�'L��S''1 C <br /> �` � � �, <br /> ( �_r- 'tr-' `��t � �c'�«1 �bt iCf�"r�L 1 c�F�r�LF4a.._n .nk-a `1�2L9 v64-n �,io <br /> Electrical Cc:itractur Mail AdAress Cily State2ip Phone <br /> U J�C� <br /> �j`,n�1.v�S�-2�'�3 lt � <br /> Slate License Number Contrad Price o1 Work <br /> . �:� �fc'_�L •1-�-rtn:- R��t � <br /> it"�('\ <br /> Proposed Use of Ouilding Conlad Person (Plan Review) <br /> Description o(Work lo BP Dcne: �,1.J ��� Q A.:�C / .cv rv.,��J ��P.T'�� � t=� ��T ��% <br /> �t-( i! "�� I�tJ�d ,n ���'�5""� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BF IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hweby certily fhaf 1 hnve rend anA exnmined(his npplication and know fbe same(o be frua ond c � � � � - j L/"Z <br /> correcf All provisions ollaws nnd orziinances�oveming fhrs type ol work will be complefed l.i <br /> whe(hm spec�IieA hcrein or nof. The�ranling ol n pemut does nofp�esume fo c�ive nuthonty lo <br /> violafe or cnncel Ihe pmvisions ol nny o(hr,r s!afe oi lucnl lnw regulnhng constniction or Ihe <br /> pedomtnnce o/consln�r(ian. Tlinf I mm�ufhonzed by fhe ownei o/fhis,�ropeAy fo pedorm fhe <br /> wnr�lor whicb npplicalion is made end 1 comply wifli fhe Sfafe Confrncfors Law 18.27 RCW nnd <br /> 296.200 WAC. <br /> ) <br /> L G� 2 � � l <br /> � � �� Y� �-- -- <br /> Signalwe Dale <br />