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�7/O1/20�8 07:46 4253�38934 EVERGREEN SECURITY PAGE 02/02 <br /> � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EV�RETT PERMIT SERVICES <br /> 3200 CEDAR STREE7, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ( �as � ��2� �v�� v���w �r2 <br /> PROJECT ADDRESS <br /> a-vl5 lf�25 � n��a-t�+NE U�ew r�2�2 �v7� w�} q8�-�f <br /> OwtlBf MailAddress City Slatetip Phcne <br /> Tenant MailAddress Ciry Stalc2ip ���p Qhon�e ...` <br /> �'�S�J'-T O—�O�J <br /> �L'V�'12C�IYL��J Li�2ut21-n{ g I 65 �2f,�9-�Ul��i'n l C✓t W l4- °t�-0 <br /> Electrical ConUaetor MailAddress Ciry State2ip � <br /> �/��Is�l � a �� �o`r��sc�o <br /> State License Number Conlract Price of Work <br /> c�U1�Vt���1`t' �aEt�t'A� �I �t�- k.v� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Bo Done: _4�tJW V ���1 Ci �:Jri C�G(.�-L l '' �`/���17�i�"Yl <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> D[ IN RACEWAYS, MC OR AC CABLE. <br /> C�TY OF EVERETT LOCAL SALES TAX COUE IS 3105 ����� _ C�oy <br /> l hem.by ceRify tha�I have read end examined this applrcafion and know;he same fo 6e hue and <br /> correct. All pmvisionS o/la�vs and ordinances govaming this type of tvork wiil6e complefed <br /> whe(har specified hereln ornot. The granting o(e pennd does not p�esume fo give suthonty to <br /> Nolsfe orcancal tho rovisions olany othersfafe orlocnllaw reguleting construction orthe <br /> P or�lc�%a vh ch appl!�OLon s mado and!comply with 1he Sfato Co fracton Law 18 27�RCW and <br /> 29G.200 WAC. <br /> � , <br /> � � <br /> �gnatcrc D e <br />