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'r,i:5 • � %I�(Ifi � : �'�r.�i1 I [�.�n�;�n SiJlt�'� Ii�C i�0• I,�'�� �' �� <br /> ' <br /> � <br /> � ELECTRICAL PERM�T APPLICATION � <br /> ClTY O� EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www,everettwa.org <br /> APPLICATlONS ARE ACCEPTED FRpM 8 Ahl TO 4 Pt�1 <br /> � �` �. i3 p >� s cyy <br /> I��FO � � (��211�Q,� � �1� , <br /> PROJECT ADDRESS <br /> � �Y � � 9�� . . � <br /> Owner MailAddreas Ciry Stete2ip Ftior.e <br /> T8�er11 Idail Address City State/Zip • Phone <br /> Tn.� � � y��� .��n�-�msv� i� �a�b <br /> EIecVIcelContraetor MailAddress � Ciry Sta!e2lp Fhona <br /> ��;�NS"��I��l N� �� , c� <br /> S a ense Number ontract Price of rk <br /> ��X � <br /> P�ioposed Use of Buliding Contact Ferson (Plan Reviaw) <br /> �eseriptlon of Work to Be Done: I..�kJw � U1 � � Q�1 U / <br /> � .� \ V' l '!1 P <br /> NOTE; WIRING IN NON-DW'cLLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS,MC OR AC CABLE. <br /> CITY OF EVERET7 LOCAL SAI.ES TAX CODE IS 3105 . <br /> 1 here6y cen)ly fhet 1 have read end exemlaetl thls eppllcallon and know the same to be frue snd <br /> corract. All provlslons of lews and ordinances gaverninfl th:s type of work will be completed • <br /> whetharspeciAed horeln ar not. The grenting of e permit does notF resum.e to plve euthorrty to <br /> violeteorcancelthe provlsionsofenyCthersteteo�locallewregulafingptonstructlonorthe <br /> wo�k fe ewhe�e��Ilcat cn Is mede snd 1 com�iz withythe 6tele Cc�trecfo spLswylB 2 RC W end <br /> 296.200 W . Pp pY <br /> �,.��J � � �3�� E'O�O.O�"��� ' <br /> �-�.SL{U <br /> Slpnature Data <br /> � I,Z C� `�`� u SS �5 - 8��3 � <br /> r <br /> � � <br />