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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-25'7-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br /> ll �4. r/,fs7,�T 5 ��`- <br /> PROJECT AODRESS <br /> A � �/y 87J <br /> ��JG�i7, 1 ��c7,t� T��i�✓,9 Ccriw� �C /t- L/� � <br /> Owner � Mail Addross Clly Slale/Zip Phone <br /> Tenanl A1ail�ddress Cd� Stat��Lp Phono <br /> . L C � �c ,f 9�otS 8" �G� 7 3 <br /> c�, sT�-,r, - r��H L/�[yc_' L (k �Et STPr�'� 5 <br /> [Ieclfic:tl COn�faGWi Id;�il AdJress �%��Y SLitn�Zip Phone <br /> � �,� r� ( �3G LT f>G S o0 <br /> Slate L amso Numbci Contracl Prico ol Work <br /> �, ,, rr��,s �, F�.� /��, <br /> Proposed Use ul[3wldinu Cun�acl Purson (Plan RevicH�) <br /> Dosr.rip�ion o�Wutk In�o Uurn�� �'jG4L ---�-✓,(STu���-------- <br /> NOTL': WIRING IIJ �JON-DW[LLINGS IS REQUIREDTO FEE <br /> BE IN RAC[WAYS, MC OR AC CADL[. <br /> CITY OF GVERETT LOCAL SALES TAX CODE IS 3105 ;�'�� j'_ I � _ <br /> I hernby ci�rtily fhaf 1 fro�e rcad miA exnmined this applieation mid know fhe same fo bo hue and I I <br /> conecf. All piorisions o!�aws mid orAinnncos,qorominc�fhis f�pe ol work�sill bo complefed �1 <br /> wh�tlhrr specilioAhi�ruin or noL Tho prnntinp o!n pennd doos nof�uosurno fo gi��o atdhonty fo <br /> viola(o ur cmicel fho r�rocisions ol any ofhor stafe or locol law rugu aling consfniction or fhe <br /> pedominnce o/constniction lhaf 1 am euthorized by fhe o�tirior o/lhis property to porfomi fho <br /> work lur n hich applicafion is nwdo nnA 1 cornply wifh fhe Sfnto Confrncfors Low iB 27 RCV�anA <br /> 29G.'100 N'AC. <br /> ��— �� . <br /> / 3 <br /> '' ) -r''.� ..�7� 19��' l �/���`�/ _ <br /> .� /- Si�7udlmc --. _—_--�—� Uaie—� <br />