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�LECTRICAL PERMIT APPLIC/4TION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREE7, EVERETT, WA 98201 G,, a y`�O <br />425-257-8810 - FAX425-257-8857—www.everettwa.org C�p06��a7 <br />APPLICATIONS ARE ACCEPTED FROM e AM TO 4 PM <br />�05 � ��--� ma.� c.Jc,,�. <br />PROJECTADDRESS <br />��R.ini�i l,Cnr�� allc�►�' C°e�, �C� � 12�113 Sh.ctu�e YYllssr+n, �'s <br />Ovrtle� �foilAddre6s City StatalLip Pho�e <br />TE11a01 <br />r �� '�5 S-c' ,��e-<.�- rta-�Q <br />f�,e. �lee�,e1� <br />Mall Address <br />Elechical ConVactor�pa(,�{( q_ ai� /uldress <br />�lq� D Q.'S R�r I P �- <br />St2le LICP_nse Number <br />Com m.e,�-c.�=e--� <br />proposed Use of 8uilding <br />!� <br />�v8 <br />c�ry v Slatorzip � Phone <br />�{dJ 3Sa'—�//oy <br />�P.2w� c.�+ 9g�p� �� s—s�a -- <br />Clry $latdZlp Phone/7y <br />� tlav— <br />ConVact Price of Work <br />�eb�ee� �%vrf{'I'z� <br />Contact Person (Plan Review) <br />Doscription of Work to 8e Done: Cl6'` ��� �C-�Tz-��5�� K%� ��'f' h� O�'Ln'�"e�'"' ���f�=r' <br />NOTE: WIRiNG IN NON-pWELLINGS IS REQUIREQ TO <br />eE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TNC COOE IS 3105 <br />I hereby certify that / have read <br />coirect. All provisions of faws a <br />wAethe� spo�od herein or not. <br />violato or cancel tlie provisions <br />per/Otm�nc¢ o(consWction. �T� <br />work for which appNcation is mt <br />286.200 WAC. <br />fhi5 apAlitahon and <br />6- <br />3 to ba We end <br />completed <br />i0 duthority fo <br />tion or tUo <br />o parform !he <br />8.27 RCW and <br />�v <br />FEE <br />� � � <br />� � �, - (a. 7 <br />� <br />aa/ae 3�ed ,r�lo3�� ��arro� 99aaa�s��,r oz:st otu��e�;gn <br />