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iz;o;izoio is:ot r,�s 425J3578a0 YdRNGI.t. IiLiiC7'NIC f�ooziaoz <br /> � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �2,�g —/D <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> Giolz�OSy <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 1a�5 ���,� r/f � t�� <br /> PROJECT ADDRESS <br /> �a/r /.o v.�,/s-✓ con r{rvc�� �h c Po Box 130� //�ar,�s✓r'!It U+.W���a 1 d 3Go'�5131 <br /> ONmer �9all Address Clty �— Statel7Jp Phone <br /> Tenant Malt Addmsa City Stato2lp � Phone <br /> (/9�'►u/� �/i��»��iu �/D/s S2°7�- Lk Sta� v� � S�8 �1t33�7��0 <br /> EleCtriCal ConUectof Mall Addross Clty St te2ip Phone <br /> U�l� tv���Q��MG �t3 70o n� <br /> Stoto License Number Conlrad Price of Work <br /> �s/`6LF�L�lYrti / � I p(Olw !'_o <br /> Propasod Use of Bufldinp Contact Person (Plan Rovlew) <br /> Doscription o(Work to Bo Dono: W/iQE ���fJ �e� � /Y�5�OC�•cy a� �P 5 i��c�o <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 CODE IS 3105 <br /> c-- <br /> I liereby cortlly that 1 havo reod and axaminod fhis application end know the sama to be frue and � U� Z -UJ Z <br /> correct. A/l provlslons o(faws and ordlnances govomin9 this typo of work will6e completed <br /> whefher spoclfiod l�er�ln or nof. The granting of a pormtt doos not qresume to glve aufhorfty to <br /> vlolefe or concel fhe provlslons clany oiher stofo or locel law regulatingpconstrucNon or the <br /> p or�l�r ore vh/ch o�pll ca�on Is mede end 1 compry w th th'e Sta e Co trs�c(orros�w 18 2 RC W and <br /> 296.200 WAC. <br /> ,��..� �'�a��.-�� la/� ��fl <br /> S�gnaturo Dat <br />