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12/15/2088 10:10 4253538934 EVERGREEN SECURITV PAGE 02 <br />� � <br />ELECTRICAL PERMIT APPLIGATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98207 <br />425-257-8810 - FAX 425257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTE� FROM 8 AM TO 4 PM <br />lY ��/ � 'r l�V�� �"V ��� <br />PROJECTADDRE9S <br />� ] � I S --0�' <br />� ogrZ.-o�?� <br />S�s �AR�,ou t,t..c. P� `�u �cX�l �1J2�IN� q8"(�0 <br />Ownef Mail Aearou clty Slile2ip phone <br />Tenant <br />Eiectnral ContreUor <br />Mall Atldross <br />tdall Mtlresa <br />'� <br />Clty <br />C�ly <br />SUIc/LP �,Zr-Phone <br />' #'iDl E1fr 3�-f$-3� <br />State2lp pryone <br />��✓c�l I'al.a �4lJhl�_ d0 <br />State I.icense Number Coniract Price of Work <br />�M�R.uA�t� uz� f�E s <br />Proposetl Use of Builtling Contact Person (P an Review) <br />�escription of Wark to Be Dona:��/� N 1 ��1w V C�1 Y�G (V �� <br />� �_ �0 utJ Vd (.-7�kf�� �1�1 r1Q �S <br />NOTE: WIRING IN NON-DWELLINGS IS REpUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TA7( CO�E I$ y�06 <br />fhal I have read and examined fhis appliCation and know thc same fo 6e t�ue and <br />�visions o/laws and ordlnenc�s 9ovemiqp fhis type o/u•or!; tti�l be comp/efed <br />'vid hersin pr noG Tho gren6ng o/ a pemfd does nofp rnsume fo ,qlva euthonty (p <br />?I fhe Provisions olany othfrstefe or IocBllew mgu/afinp const�ucfion or fhe <br />epP�l/catiCon / s�msde� antl f comptyed(d (rye Sf te Co f acPrs la�y B.��RCW7end <br />�� I : <br />FEE <br />Ec�� �a -� �� <br />