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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES 3 � 7_0 8 <br /> 3200 CEDAR STREET, EVERETi', WA 98201 <br /> 425-257-8810 - FAX 425-257-8657 —www.everettwa.org �p �0 3.-04� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> y�30 Cc! �-, �l v c <br /> PROJECT ADDRESS <br /> ���,�, lo !; � <br /> Owner Mail Address City State2ip Phone <br /> Tenanl Matl Address Cily State2ip Phone <br /> �n-f�u1�Fl�cfr;z�l loYZT 92 �� IC L�k�f-l�vr� � 5�"tl� (y1-1 U5',c6i7 <br /> ElOcltieal Conlr3clof Mall Address Cily State2lp Phone <br /> (�!��-o�Cl 9 S Z Q G yca o . °.. <br /> State Ur,a;�so Number Conlracl Prico ot Work <br /> Proposed Use of Building Conlacl Person (Pian Reviow) <br /> Descdption of W ork to Be Done: �/1f I� �I e I�� �/I�G 1 �Zl� '\� ��� �PM 0�P l <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CADLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> 1 hereby certi/y fhat 1 have re.�d and examined this applicofion end know fhe same to be frue and I <br /> correcf. A/l pro��isions ollaws anA ordinances govemmg this fypQ ol work will Ue complefed � <br /> whelher speciGed hemin or not. Tho granting o/a perrtvf does nof presume to give aiRhontylo � <br /> violate or cance!the provisions o!any olher sfute or local law rec�u/afirn c�.asWcfion or the �- <br /> performanc�o/consln�ction. That I am euthonzed bylhe o�rner d hiis property fo perlonn ihe <br /> work Ior which applicafion is made and!comply with the State Confrectors Law 18.27 RCW and r1� <br /> 29G.2D0 WAC. �� <br /> /V <br /> 3�7�0� �✓ , <br /> Signature �e�e� I <br />