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i <br /> i <br /> ������, <br /> ELECTRICAL PERMIT APPLlCi4TION <br /> CITY OF EVERETT PERMIT SERVICES c� � s..,r Y <br /> 3200 CEDAR STREET, EVERETT, WA 98201 ` ` <br /> 425-257-8810 - FAX 425-257-8857 -www.everetlwa.org �U}��`j_/s <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> IiLz �_ti�;��;r�zu Si. Cv�'z,,ir w�� 95Sz�K <br /> PROJECiADDRESS <br /> ���L�1u1_I r� ��i �4i �—CT �� L.L L' � Ci'J-�;G 4��T�F �i1, w� �7'�D 1�iP�A�f.�n�i���J� '��'i�( <br /> i <br /> Owne� �dail Address Ciry Slate/Zip Phone <br /> Tenanl MailAddress Ciry S�aie2ip Phone <br /> >> It,L �� r� ���� f�,�ti�, ��� �r.:��> �����1� r�,�� n�r ����,,> >�, �� ,y �,»� �r�����j�g,� ,, <br /> EIECUical Cont�actor Mail Address City Stale2ip Phone <br /> 1'�F �2 IT 1'l11 ��l R/�1 z-LU '.•• <br /> Slate License Number CoNract Price of Work <br /> I�fl�_iN-Fi_ l��-r�,n,j <br /> Proposed Use of Building Contact Person (Plan Review) <br /> DescriptionofWorktoBeDone: L+�i ; L ��;�ic:x � (Z� T-Srd+Ts . <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CO�E IS 3105 <br /> I hmeby certily fhaf!have read and eeantined this applicafion and kno�a �he same lo be Irue and <br /> conect All pravisions o/Imvs and ordinances govemmg this type o/�vo�ti nall Ge completed <br /> whefher speci(ied he�ein or nof The granting o/a permd does nof presume to 9ive aufhority fo <br /> violafe or cancel fhe provisions ol any o(her sWfe nr local law iec�ulafing consfruction or fhe <br /> pedormance o/consfrucfion. Thzt I arn authonzea by fhe owner ol fh�s piaperty fo pedomi fhe <br /> wo�k Ior which app6cafion is made and 1 cornply�vilh the Sfafe Convacfors La�v 78.27 RCW and <br /> 296.200 WAC. <br /> ` ` � � <br /> ;., <br /> � <br /> ��, , � � � ��__ 'V �1��-��� ' � �_" <br /> �� Si nature Date ' <br /> �� � � �� ���. � � . <br /> L <br />