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ELECTRICAL PERMIT APPLICA710N <br /> GITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAk STREET, EVER[TT, WA 98201 <br /> 47.5-257-t3F310 - �AX 425-257-8857—www.everetrive.org <br /> ApPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> _G,�I�Ii l sl- �I;� } E�e�e-j�q87ss�{ <br /> I'ROJECT ADDRESS <br /> �,�rnQ.ts�l-o n.�F�e�,S `PO f�c 1 y�12y M� � � rV�p,� W ql���y�S,338- �t's <br /> py,mL� I.Aall AtlAreSs Gity SlaIc/LD Plwne <br /> Tenant Mail Acldicss Cily SI3Io2ip Phone <br /> �r�Gsioil ��ec�YtC 3�L'�ar�i,2� S�• rn�vn l:nu� V�7(a 91�OZZ �314��525�3 <br /> GICcViu3lConlroMo� MallAddrc:^ City Sta1elZip Phone <br /> 7rec� ee98tiL5 � ?�•00 <br /> Slale Li nse Numtx3t Contrecl Price of Work <br /> S t nn�i e� �u w�i l� �i2.2w �re,Sldevi c,�, �'�''�'�-- <br /> Proposed Usa Building Contact Pers (Plan Revtew) <br /> Squam FooWge pf rnsidenNel new consUuction,remod¢I or adddion) <br /> Description of Work lo Be Dona: �e}�.� � _ <br /> � <br /> NOTE: WIRING IN NON-0WELLINGS IS REQUIRED TO FEE <br /> [3C- IN RACEWAYS, MC OR AC CABLH. � � � <br /> C(TY OF EVERETT I.00AL SALES TAX COOE IS 3105 <br /> 1 hpreby codify Oiaf 1 hove reatl and examined(h!s applicoGon anJ know the same to 6e truo and <br /> carract. All pmvisiuns o!leaws and o/dinaneas,qovammg this type o/wodc will to eomplvtcd <br /> Whothcr spcufi�3tl herar�0��Ot. Tha g�nting of a pemtd dces not presume l0 9ive BUthonty fo <br /> viol5fe or c�ncd fl�e provialons o�any other sfnte orla:sl Imti•rogulahng consttuction oi fAe <br /> peAortn�nCe Gt r�nsJr�iction. Aiai!nm authorizod 6y(he o�vner ot this Proparty fo pudam the <br /> work lnr�vhi,:�applicat��n rc mndo and I ccvnply with the Slote Contrncfors La�+� 1827 RCW nnd <br /> 296.200 WAC. <br /> —___�..���It-�. �2� 13f 12– -- <br /> si9�a �d� oaie <br />