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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVFRETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -vrww.everellwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> I �2(o Ck.eS�h�+ g�l-- <br /> PROJECT ADDRESS <br /> uila.ta$cr •. nlulBesr <br /> ?ra c.� Dt+a�oc1 �^�¢t 11 I _S._Fe.r t�'ls+�ro� W/� 9 fl2'12 3fee)g�S-88 <br /> IOwne� 1.1aJ�tldress � Gty State!Z�p Phcne <br /> `���---- --- ----- 20(0 9�D-8335 <br /> TCnant MadA�i�ess C�ty SlatelLp Phone <br /> o gox 2�08 Fu .-C..� .,�� 9K2�f8 (s�^0)3�- <br /> 1nd�a�ca.���—a"' — "`� — 990 <br /> E ledncal Contractor h7aJ Add�ess Gty SlalerZ�p Phone <br /> �i�l fjFr/�C,��I ILS <br /> Slate License Number Contrad Pnce of Nbik <br /> Propnsed Use of DuJd�ng Ccnlacl Person (Plan Revie�v) <br /> Squaie Foolage Qf residenlial new eons�rudion, remodel or addilion) <br /> Uescupl�onofWoik �oOeDone� T�T Wif'Q ' Li� i!1 �i��d� � C W�Ll �q�S) tufrlaCP_ <br /> - CJ <br /> NOTE: WIRING IN NON-DWELLINGS IS R[QUIR[D TO 1 FF. <br /> Bf IN RACEWAYS, MC OR AC CA�Lt=. ��� <br /> CITY OF EVERETT L9CAL SALES TAX CODE IS 7505 -- -- �--- ----( <br /> 1 hem6y certdy fhal l have mad and examined fhis applicalion and knoiv thc sarnc lo be l�ue and � I �I � — I�j I <br /> conect. All provrsions olla�vs and ordinances govemmg Ihis fype ol�vnrk m�i0 Ae comple(ed <br /> �vhether sprcified herein ornoL Thn, granfing ol a pemvf does nof resume fo give nulhonty(o <br /> violafo or cancel!he provisions o(any ofher s(afe oNncal/mv reguPfing consfrucfron or fhe <br /> pe�fom�ance o/cons�ruction. That I anr aufhonzed 6y the ownerollhi,.nroperty to perlonn fhe <br /> woiN Ior which applic,�tion is made anAl cony�ly wdlr Ihe Sfato Conhacfo�s La�v 18 27 FCW and <br /> 196.200 WAC. <br /> ��'`-+.� �'-�`-`-d'� 12�ZT�2o1� <br /> Siqnalure Dale � <br />