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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETI�, WA 98201 �.3 � 7 — ll <br /> 425-257-8810 - FAX 425-257-8857 —�riv�rf.evereltwa.org <br /> E wi � y3—� � <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 3 � i �/ C J I IJ �, �,L�l� <br /> PROJECT ADDRESS <br /> r\ -7 <br /> 37 �c�(1��,, 7rc��el' � i'tS �. ( izn�y tvn`s�<,t LL �J ,ns tuAy'q.t -�ss�91957. <br /> Oi5'ner A il Address <br /> CdY Stale2�p Phonc <br /> 3 �'� C,� 13�� �� C � z�lv z � u <br /> Tenant e?r�s�Stl.�l=5(����.�< <oa► 4'��S„ �I15SvY-z�SL <br /> 1.1ai1 Address Gty Stale/Ly Phone <br /> ��,��� -,(v,-� � rr� �� � I� -►kir�.� � f��r>. �j� 6G �,�.� s �� ,�v� �i.°;,p�j <br /> Electncal CoNractor M �I Address Gp- 5tatcidp pno��� <br /> L��n s i R 1 99/�lU <br /> Slate License IJumber Contricl price ot Work <br /> J:�� � �i.� sc���sz <br /> Proposed Use of 5uilding CoMact erson (Plan Revie�v) <br /> Descripiion o(Work to Oe Done: �I. L'�r' � 1 h y��� /� . <br /> NOTE: WIRING IN NON•DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, hiC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS�105 - <br /> I hereby certily Uiaf 1 heve read and ezamineA Uus app6caficn m�d kno�v Ihe sanie to br. fruc nnd <br /> cornd. All provisions ollaws and ordinances gori>�mng Ihis lype o!work �sill Ge complefeA <br /> whether specified herein or noL Ihe g�an6ng o(a perrnd does nof rresume to give mAhonly to ) <br /> violale or cancel the praosions ol any other sfate or local law re�u�efmg consfnicUon or Iho r- , 3� / <br /> �o,rh I o�av�ilch ap/N c�af or��is rr a'dc or�clf anr ply��fb thc�Stafe CoOfracl�rs�LaMv ld 27 RClNand � w Il� <br /> 296.�70 <br /> :" Signatur � � _� a' <br />