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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 /4 —1,3 —Q(� <br /> 425-257-8810 - FAX425-257-8857—www.everettwa.org �6�D—vd� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> , � <br /> `. '� �� � �Ci cl y�, J I. <br /> PROJECT ADDRESS <br /> ,� . <br /> �Y ��l �1 r � v <br /> ner � Mall Addross City State2lp Phone <br /> Tenanl Mail Address Cily SWIe�Zip Phone <br /> 3(c0 (cS`t" I ���� <br /> � � `� ��Pc7ri � �� ��r�c ly � _ �11ur��-��, l�e �.�Jl� �t �2�o -- <br /> Elecldcal Conlraclor Mail Address City� Stale2lp Phone <br /> F�'�'� G � �_ � �: r_��� � �-i�. � �� oc�0. �� _ <br /> State Liconso Number Contract Price o Work <br /> � / �} � y� �� �� S /' � <br /> �� ��✓l ��.�U�]�� � L � ���1 I � � 1 VS� C� L\ � J.L� '�` I�< U l � �_. <br /> Proposed Uso ol Buildinc� � Contact Porscn (Plan Revlaw) <br /> Descrip�ionofWorklo �eDon¢ � �J L��-�L� � ����-V �C f - �C ' ��L�A <br /> ��l�n.�� �, �,J � �� �n �� SSUC � ��i� IicI� T - fti �1 tluT�� 2�S , <br /> � r� u� i <br /> ' � r �1'f' �` �� (P ��'-1/v1n 1�.1 � (, � r� �� �" �'�L�i � <br /> � + �— <br /> NOT[. WIRING IN NON-DWELI.INGS IS RE�UIRED TO fEE <br /> �E IN RACEWAY£. MC OR AC CAaLF. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I heieby cmtily fhaf 1 have read and exnrnineA(his epplicnfion nnd know fh�sarno lo bo fruo artd <br /> corrocf All prov�sions ollaws anA ordinances,qoromin,q fhis type o/Hvrk will be completed <br /> whethw sper,ilivd herrin or noL The prantint�ol n pennd Aoes nof �resume fo give euthonry fo <br /> violafe o� cancrel the I�rovisions u/eny ofher sf�fe oi locel lak�regulefin�conshuction or tbo <br /> perfnrmnncr n!construchon. Tlfat 1 nrn nufhonzeAby fhe owner o/Ihis properly to peAomi the <br /> work!or which npplication is rn�d�and 1 cbrnply �rifh fhe S(afe Conhncfors Low 18.27 RCW and <br />� 196200 Vl'AC. - � ' <br /> _ � y <br /> � <br /> 1 �,'.�J � � ��'�G--- I'� ( � 0�, r ,� ; <br /> � signa�u�o Da1e � �. — .. `� <br /> i I �� <br />