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� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERET7, WA 98201 <br /> 42�257-8810 - FAX 425257-8857—w�vw.everethva.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br /> �-��! ��� <br /> �l �/a�- �D6 <br /> `�0`�0 ��, ,� v1c.w �\ vp <br /> PROJECT ADDRESS <br /> E \�"�c�.��� 1��v.� � �_ <br /> Ownor Mail Addro Ciry � Slatetip Phone <br /> Tr_nan� MeIIMEr¢os �0.Y StatelZlP P�ano <br /> ��.n L�a.-�t�� ��Do l s I 3�h �� �_S'�_ -.,i.l�t L�c�. q gl(��� <br /> FlacUicalGonUaC,or Matlqtldresc �iy �e��p <br /> ac�.a� ����oc� <br /> ��a`� �q �'�oo <br /> btate License Number COntrad Price of Work <br /> �'� 0. ._.�.:�r�a;,-e._ <br /> Nropased Use oi Bwlding Contact Pcrson (Plen Review) <br /> Desaiption of Work tp e Done� 1 � c�,lyl,�\ C� r L v\ �T- �r <br /> ' C .� I a f -� <br /> NOTE WIRING IN NON-DWELLINGS IS REQUIRED TU <br /> B[ IN RqCEWAYS, MC OR AC CABLE. FEE <br /> C�TY OF EVERE7T LOCqL SaL[3 7Ax CODE IS�106 �oo� <br /> r hereiy cert;fy motlAove reao and examrned mis opplicah'on and know Ihe samo fo 6e huo and <br /> CorraU. Ai!provlsrons ollAws and orti�nnncas govemmg lhis ype of woNr wd!Ao cnmplolnd ( /� <br /> wAefhor specifie0 Rerein ornoL Tha grAnfl�g o�a pa�Oocs nof ornsumv fo glvAauMonty to �I�O�� I O t!J <br /> �rolafe 0�cancoJ(hepro vrslons of any oMer state orlocaf law regulab'ng r.Onstruc6on orlha <br /> P��wmonce ol�ronstrudion. 7hot I am auLhorized by tho owner olthis prc�prry to perf���he <br /> lw tvhich applrcoAon is mgtle and I c�omply w(y�tho Sfafo Con6nc/prs LaW 18.27 RC W a/lU <br /> � . 0 WAC. <br /> �BnaNre <br /> ` � g I �I <br /> Dale <br />