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i <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—www.everettwa.org y� a 3—�� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 pM G��D '�'J�l 3/p <br /> 300 3 W Cas�n o �CU1 �'�IS - 3U',� C�uei{-, wA 9 � �-►3 <br /> PROJECTADDRESS <br /> (Al� st�.a. cor�5'�:uc�,on� <br /> ��i�n� Co �� 13oy� Z8U P�H�,,�,� wa �k3 �� y�l6 3y6� <br /> Owne� Mail Addrass <br /> Cily Slnle/Zip Phone <br /> `� 3vo3 W Lo.3� C1u Q�� <br /> WDeth r�.. <br /> —�J (�Q-f Crtw F'. -fi- q�'l1 <br /> Tenan� Manqddress - �� 3 NlA <br /> Cily S�ale/Zip Phone <br /> � � o.c onwlc� lM,\l.lt✓ "17�--� Ocl-rof� /�v-� S� �}{, Cauc) <br /> Gecinr�l CoNractor MaIlAOdress �� �� ��� � ��o y�7 p <br /> C�ty Slale/Zip Phone <br /> M�9� _'� oMr- 9�a �F �/�✓v5 � `� w �/� <br /> Slnle Liconse Numbcr <br /> Contracl Prico of Woik <br /> �o v�n h�tr-� �� /� ��/21) <br /> Proposed Usa�;Building �1�� I�� / q �-7�a b�S 7 O <br /> Contacl Person (Plan eview) <br /> ^�°�•'p;;on a(Work to Bo Dono: Gl��Q � �p � � �/ <br /> --._�- _✓ U �Aqp �—SI-A� Cr./�� 07Z-�s� <br /> �� �vW J�"IZl. (`.,.0✓'�T�i�o <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br /> B[ IN RACEWAYS, MC OR AC CABLE. FEE <br /> CI7Y OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereGy certily flraf I/rave m»d end oxamined fhis applicetion end know fhe seme lo be frue enA <br /> r.oirecL Atl provisiorrs ol Inws end orJinnnces goveming this typo o/work will be complefod <br /> whvlhor spoaGeAhercin or noL The grnnfing ol o pemrd does nof presumo fo give au(Iranty fo <br /> violale or cnrrco/flre pmvisions ol eny nfher sfafe or locn/Inw rogu/eting consfnicfion or fhe <br /> �wo�k/or�wh ch n��l caf on�s q��r7e and I c�omply wi(�(ho Sfafo Co/frac�oisP ewy78 77 RCW�ncd <br /> 79fi.200 WAC <br /> iyn��,F °`-."'� _'�,�„" 9 - Z3 - o� <br /> �l12LI1 �OLL Uale <br /> �o��ti - � . � L <br />