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ELECTRICAL PERMIT APP�ICaTION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, E\..'ERETT, WA 98201 //—la�p�� <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org C O�//`�� <br /> APPIICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> I s o �' C��I�);� Q�U E . <br /> PROJECT ADDRES� <br /> ' y ��0.0 '�ti;t+"!f'k�ti'�� ��dG e.b�l?U HU�� �V� wQ �11J - �4L - y334 <br /> Owne� J 0�tailAddress Clty Stale/Zip Phore <br /> Tenanl hlailAadress Cily StafelZlp Phone I <br /> Eledrical Conlractor Mail nddress Gty S�ate2ip Plione <br /> L��r �� C, .� q�(l rn ti <br /> Slale License Numher Contract Pnce o1 Work <br /> ( Ro� �.v����C`^� <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Descriplion of Work lo�e Done: �l��l� i'Xf'I�. �T �y,K n�l.�,,o� �7�0 "'�JU/¢ h�q.f�+- <br /> ���iZ� C�.��tK' e I <br /> �JOTE: W IRING IN NON-DWELLINuS IS REQUIRED TO FEE <br /> RE IN RACEWAYS, MC Ofl AC CApLE. <br /> CITY OF EVERfTT LOCAL SALES TAX CGDE IS 3105 ��' ' _ �/ <br /> I hereby cemly 7haf I h,ave read nnd examined f0is applicafion and kno�v the samo to be true and �U � J <br /> correct. All provisions ol/aws and oNinances govemmg thls type of K�ork will be cemplefed <br /> whether specilred herein or not. ihe granfing ola permd does nof �resmne to give authonty fo <br /> violafe or cancel the�rovisions ol any oth.r state or local lau�regu�ating construcfion or fhe <br /> performance o/consfrucfion. Thaf 1 am authcnzed by the arner ol fhis property(o perfomi the <br /> wvrk lor which applicafion is rnade and 1 comply wifh the Sfafe Crnfiacfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> L� �^ � �- `- 1 /%- /�j - O S <br /> SS:n,tLilr, D31e ' <br />