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p. l <br /> r <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES ' <br /> 3200 CEDAR STREET;EVERE7T, WA 98201 <br /> 425-257-8810 - FAX425-257-8857—www•everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> yd/9 �', GI.F�u�n.V',E•c/ D 1�► y Zf <br /> PROJECT ADDRESS �G O <br /> G � � w r�� e�zo <br /> 3��' <br /> Owner <br /> MsllAddrosa GlY Smte/Zlp Phona <br /> Tenant A7allAddroaa � ' Clry Snte/np � Phone <br /> � �f <br /> �XS 3Go FrU ,bcv P'-.v 9e"�a/ Z� � <br /> F�'��vn� Phons <br /> Electrical Conhactor Mall Addrou Clty S�t�D <br /> 1.:(`��/�'r �yZ Lp ContrndPrlcaotWork <br /> Stale Llcanse Number � <br /> Sr� ConlaC Person (Plan Review) <br /> Proposed Use of 8uilding <br /> Desc�lptlonoiWorkto Be Dono: �l�C�N � ��7 �nDOM _R�L�pT�" �'^�' <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE �S <br /> F3E IN RACEWAYS, MC OR AC CABLE. �� <br /> CITY OF EVERE77 LOCAL SALES TAX CODE IS 3105 <br /> I hereby cortl/y thot 1 have raed and vxeminod mfs appllcafion and krtow ihe same fo be truo and <br /> coneCL Ail proNsions oflews and oMillBnCas yoVeminy thls fype ol work wlll be corTipfeted � <br /> whefhor speClflod hBroln or nof. The 9fanNng OI B permit tloos not resume to glve euthorrty fo . <br /> vlol fe oY Cence!thB arovislOns ol any other Stete or locel few repuPtln9 conslruCUon or the � � <br /> por�ormence of construct;on, 7hat!om euthorized by tho owner of thls properp�to perform the <br /> 2D6 200 WAC gPp��caUon Is maCe and 1 comply wffh!he Stata Contrac(ors Lew iH.27 RGW and <br /> ` // �� o � <br /> ature �1° <br /> (1�/� ' '-��' <br />