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.' �6 � 33�3-5 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT. WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -�wvw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �IQ�J 1/JC�'�i' C{}�,'� fzeA-� �A��i � — `W 2 <br /> PROJECTADDRESS <br /> � �-1�(� (10. '�OOyf �"7rA � (ZP- C�/�^�l ,� ��' � <br /> CiWner �ABdntltfress Cily SifllelZio Phone <br /> !�� �S �`�'� -- -- <br /> 7enant r�nne naa�ess Giy SiaierZ�p ahone <br /> �qiF� (23(4� I���wo�lv�.WR- 9005z � 4�• �0000 <br /> FIPCtnCal ConUec�or Mail lltldress City SlalelZip Phone <br /> ��� oei9 ��- s9 � �o2r �oo °�- <br /> State License Number Contract Pnce of Work <br /> P�oposed Use o��wldi�� Contact Person (Plan Review� <br /> .��^��.� �.�(,�cq��,7 �pOULRYL �J1 �Ih��7 <br /> Descnphun of Wark to �e Done T ""' <br /> �'r4o I� ^ f�'� '�"�� �1- t�1� �•vta9rl vi�. <br /> NOTE WIRING IN NON-OWELLINGS IS REQUIRED TO F� � �� <br /> 6E IN RACEWAYS. MC OR AC CABLE � � �— <br /> • <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hnieby�;e�iJv fh�f I have�ead and o�arninod this apP�rcahon�nd kno�v(ho same fo Ae tnie and <br /> correct All p�ov�sions ollaws and orAinances govemmg flus type o(work wdl be completed <br /> �vhnlher specr6r,d heiern or no(. The granhng o!a pormd does nof prosumo to gn�e a�rthonty to <br /> VlUitllH UI CHIICni Ultl�7NVi5iJ/15 JI dlly ofYer;tate orlacal�a�5�rogulahng ca�stn+c!ron crthe <br /> pe�formonco ol consVuc(ion That/am authonzod by fhe owner ol tbis propeRy fo peAorm fhe <br /> �vorh lor which apphcafion is maAe and I comply�wth ffrn Sfafe Conh:�cfors Law 7B 27 RCIN and <br /> :96:00 WAC. <br /> � � �� _ � (t/2L O� <br /> oiynalure De�e �. � <br />