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,i��n. 24. 2'J1� 2:29PM '�c. ;'.i;S �. 2 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVEREIT,WA 98201 � �a 5 _� 3 <br /> 425-257-8810 - FAX 425-257-8857—wavw.everettwa.orp <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM �� `30 6 �-( �II <br /> '�3 v (�l.e+J(kk�enl b�. ��'�k �f�Za3 <br /> � <br /> PROJ[CT ADDHESS <br /> '�Mt-kvL �cv�+�Ds NfiS'3 w G-+-��hvenJ Wt_. ���', Wk �fSfZ�'3 <br /> Owner Mai�nddmss City �� Slste/ZIp Pn�ne <br /> 5•1�t+1� r�-S 1a-120�� <br /> Tenant Mail Address City State2;p Phone <br /> ��u�� �ou�Gv _T�L�'tk2tG Sva E ,��FI�J 1�oas2c:►E W� ��Z72 <br /> Elec ncal ContraClor A1ail AtlCress City Sule2ip phone <br /> G-s� �i35rr-� �3�v <br /> St3te LicenSe NumCer Conlract Price of Work <br /> �H� ��N ¢a�..�a <br /> Proposed Use of Buiming Contact Person (Plan Review) <br /> �Zf-2�Z• yNoZ <br /> Description of Work to Be Dane: <br /> �� �nlT� kiN� lUl4+✓/L+�L L�k�N�wLStF�kFiuL— .C.v�`'l <br /> ����� ��� � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> DE IN RACEWAYS,MC OR AC CA[iLE. <br /> ���L_. <br /> GITY OF EVERETT LOC�L SALES TNC CODE IS 3105 <br /> 1 horoby cortify fhat I havo road and examined this applicafion end know the snme fo 6e true and [� 1 J � ( <br /> cor�ecL All provrsions of laws and adinancos govern��g this type ol work�d/l be comple(ed �— 7 C ' — I 7 <br /> whefher specif+ed herein w noL The granting ol&permit tloos not resume�o give aulhonty(o <br /> violofo oi cancol the provisions of any olher sfafe or locellaw reguPtmg constructron or Ihe <br /> performance o/conslfucti0�. ThAI I ar1�authO�Rsd by fhe o�mer of this property fo perform the <br /> �rork lor which application is made and I mmply mth!he S(ale Conhacfors Lew 18.27RCVV 8�d <br /> zss.zoo yvAc. <br /> � , � GIZ�i �r 3 <br /> Signa ure Daie <br />