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ELEf�TRICAL PERMIT APPLICATION <br /> CITY GF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 96201 <br /> 425-257-8810 - F/JC 425-257-885i —www.everettwa.org <br /> APPLICAl70NS ARE ACCEPTED FROM 0 AM TO 4 PM <br /> PROJECT ADDRESS <br /> I l�i ,qc � I '� It '"" <br /> ,�LS'ct r --- _ nvr" S F 1- �� � f� -( «�,� y�i�'� (rz;)�s�,-c� s <br /> Owner M11a�l Addmss Cily Slale/Zip Phone <br /> Tonanl A1all Address Cily 31ale2ip Phone <br /> �) <br /> i'[UPr CliC�rz�c /�s'�s" /itcti nv'C ,}lr_'- %dl�lj� �Sr1 `'t'�� , i �3E��1-��r- L79 � <br /> Electrical ConUac�or �dail Address City State/Zip Phone <br /> �c���;_,�r_ � y9��.s .� %�G� = <br /> State License Number Contract Price o(N'ork <br /> Proposcd Use oi Buildin�7 Conlacl Ferson (Plan Review) <br /> Descriplinn of�VarV:lo �c Dnnc�. _��/E �! L�) j,�vi F�� ��'� J � l � 1 . <br /> NOT[: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE W RACeWAYS, 64C OR AC CADLE. <br /> � CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I he�eby ceAily(haf I have read ond examirted Ihis applicaGon i�n�;krow fhe sama to bo tree ann <br /> carect. All provi:.ions olla�rs ond ordinances govennng this tt�pe ol u�ork will be completed <br /> u�hetner�pecd�edhue;n or noL The yranting o(a pemuf does nof resume to give aufhonty tc <br /> violafe or cancel tbe/irovisiena o/any other state orlocalla�s reguPfing construc�ion or fhe <br /> pe�formance o/censlniclion. That!am eufironzad by the o�ti ner o/this properiy tu pedonn fhe <br /> work lar�vhich applicafinn is nrade and 1 compl}��vifh the Stafe Cen��er�ors Low i6.27 RCN'and <br /> 296200 WAC. <br /> . ` <br /> , ������-�`�� l'/ �,� G'� � _ <br /> �.-"�Si�n IGre `.`�.- Date �� . � .��: <br /> � ` <br /> __`�__ lC,"�C� <br /> �I '� <br /> t---------- ------ - <br />