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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, VJA 9b201 <br /> ' 425-257-8810 - FAX 425-257-8857— tivww.everettK�a.org <br /> I <br /> APPLICATION5 ARE ACCEPTED FROM 9 AM TO 4 PM <br /> � � � '1 � "� i r Qild� �q,� r <br /> � �o � G n C� (n. i <br /> PROJECT AD�RESS � <br /> i1. / / <br /> E���i;lbci( { �'1.'�ri'r�� �'neti � ��i���� l'7_ � fJb6l�I �yhnwr,�-� WA `1YG.�; �D6 22b �% 78B I <br /> Owner Ma7 ACdress Gty� StatPlZ�p Phon^ <br /> TCnanl Idail Address Clty State2lp Phone <br /> ��t�r' �'�idl:�l"rC_ U�i,s S1/ �L l�2� �`•5 l�/R / �j�S� vzs3�s �60C <br /> FledricalConUar.lor Ma�iAcdress City Stat�l7Jp phon= I <br /> � �/ <br /> 3G <br /> � r�2,��x� a7 SM s ��� � y� <br /> � Slale License IJumber Contract Price of VJork <br /> Sr'�l`� I <br /> Pwposed Uso of Building Contacl Perso❑ (Pfan RevfewJ <br /> CescripLion o1 VJcrk lo Be Done: W�� AiUrJ /BQ(J SG .�f .S P (Z �-OGA �-/dfC_'Q„ <br /> �_�{'Lfi,t,�'I Srnn,�D l�`� �Ndy!l�2 �Gr�In,���t4, Ca�.%rr�n-r�rorL <br /> NOTE: WIRING IN NON-DWELLI�JGS iS REDUIf2ED TO FEE <br /> DE IN RACEWAYS, f�iC O�AC CABLE. <br /> GITY OF EVERETT LOCAL SALES TA%CODE IS 1105 (- (,_ . I_ - (�. ' J� <br /> 1 hereby certify thEt I have read and examined this appl�ca!icn and F:r,ow the same to be trt.�e and �_ - " �� i <br /> correcf. AI;p;ov�sions o//aws and ordinances go��em;ng fhis type cf�rerk wiN be compl�fea' <br /> �5hethe,-specifred berein or noL�Tire grntirtg cf a permd does nof resume}o give authont}�te <br /> vlolate or car,cel!he provls� s c��ny cfher state or loca!!aw reguP(ir,g construc6cn or the <br /> perlormanc?d consL uc'ic�Tho�i sn authori>ed by the owner o�tf,isp roperry�to perfcrm 7,5e <br /> w��k Ior�rhicA applicationA;madc ard f comply v:l;h fhu Sfafe Ccnlrac(ors Law ;8.27 RC'A�ar,d <br /> 295.2f10 Ih�AC. <br /> � <br /> i /�, <br /> !� �) <br /> l��,i .�- r�t.'�.{i � L—�O <br /> Sgnature ' Date <br /> � I <br /> b d £95L9E£SZV ��ewe� ena�S e6l 80 8G Ol i�f <br />