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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT pERMIT SERVICES <br />3200 CFDAR STREE-T, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-25�-8857 — www,everettwa.org �j— L� �- �3 <br />APPlICA710NS ARE qCCEPTED FROM 8 AM TO 4 PM <br />� 3`!oZ %e ef'G!/e.- �-- <br />PROJECT ADDRE$5 �y` ' �� � � �� � � <br />Ownr.r <br />Tonnnt <br />�0.� 7 <br />ElocVical Contrecta <br />Atoil MCrcas <br />A�ill AdSt�ss <br />� �k.0. ox lq <br />Mml ACdn-ss <br />tZVZE�a�tl C J <br />Sta!e Ucer,9e Ni�mbcr <br />S FR <br />Proposr.d Use of Building <br />7 ilOt� <br />Squarc Foofnpe (If rnsldenqal nc.w conslrucGon, remoAel ar addilion) <br />Gly <br />� <br />ary <br />Statx2p <br />Satn2�p <br />S1eteTp <br />E�3n6- n�i7 <br />�'ncne <br />l 3bo� <br />Phonc <br />-�8' Sc� o <br />Contrect Ace m Wortc <br />��� c���,�. �zo, <br />Conlaci Percon (Plan KoNewj <br />Descriptlon of N'oik to (3n Dony: I'i4 i S G. e% �'y� Ga% r `' <br />!'Yll`�[ZiC. L�—�/O.II " /7ov.�. l..�A.S Jy i"�.,�_ <br />O� I/'Ln.-oc�l� (.vo�•�� L✓fit,.. ��' L�9f <br />!I � ���ss�l. — <br />� <br />�- Lic�,f� .� <br />N07E: WIRING IN NON•pWELLINGS IS REQUIRED 10 <br />f3E IN RJ�CEWAYS, MC OR AC CABLE . <br />CI7Y OF EVERETT LOCAL 8ALEg TAX CODE IS 9105 <br />I hnmby corh7y fhnt ! havc iya0 errd oxamined thls eppllc� <br />r,nnecf. �11/ pmvJslons o/laws and ory�n&nces goveming <br />violatn or �n� dhap iovlvions of einy o�ihner ��e o(tlo al <br />pe�fwmbnco nl consfnrcllon. Thaf 1 rim oufhortmd bylhe <br />wnrN lor which opplicaflon is modo and 1 compty w11h Uro ; <br />296.200 WAC. <br />� <br />� know Ne sam�v to bo Wo ond <br />i ol NviN kill be comp/otod <br />�t prosume to pNe outhonfy m <br />ulafinppconslrocL'on or Nn <br />n6ac(ors Law 1b.27RCW�and <br />6• 7- �� <br />n,,� <br />FEE <br />7S °i� <br />�I 30�- �y <br />