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ELECTf�ICAL PERMIT APPL�CATION <br />CITY OF EVERETT PERMIT SERVIC�S <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-25: -8857 — �w,�v,�.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PA1 <br />%D��3 4[f��%�r l�/,�T <br />PROJECT ADDRESS <br />LO�1/J� 2 C� sleCi/✓1 l��. <br />Owner <br />/�L2Z <br />h;ail aaaress <br />City <br />g_�.iz <br />C'�Za �- —076 <br />2oGS�y �z�� <br />�e /N� ��/�S <br />Slatn/Zi� Phcne <br />Tenont M1tylAddress Cdy Slale/Z�p Phone/' <br />�1� �%.S y-J� <br />�unsf�a-�?r.���/,./— �0.✓�4X /3a __�va�-c-� ��. 9��7c�G 9� <br />Gleclrical Contractor �� ntau Address Gty • sea�e2ip PC; n�� <br />l� (�Ns rt3 i �)9i �io �� <br />State Licensc NumLer <br />i <br />d�Fc,f Sl�f%��= _ <br />Proposed Use of � ildiny <br />D <br />000 <br />CCnlr��( p�ice Of l'VOrY. <br />Lon /1.� �• `�X�J"—! �(o Si� <br />Contacl Person (Plan Review) <br />NOTE: WIRING iN NON-DWELLINGS IS REOUIRED TO <br />HE IN RACEWAYS. MC OR AC CA[3LG. <br />CITY OF EVERETT LOCAL SALES T! Y CODE IS 3105 <br />I hnroby ceitily Ihaf ! h�ve iead nnd eaamined this application and know fhe same lo be fiue ond <br />conocL All pruvisions o(la�rs and ordinances governnir� fhis type ol �tiurk n�ill be con+plr.led <br />n�hefher specilieA he�ein or not The �ranfing o! a pennd does nof resume fo gi��e aufhonty fo <br />��ielofe o� cancel the provisions o! any ofher sfate er local Imv reguPling construcfion or the <br />peAormance ol consfrucfron. ihaf 1 arn aufhorited by Ihe owner o/ this property fo perferrn (he <br />�vork lor �vhich applica(ion is made and 1 comply �vifh the S(nfe Contrecfors Law iQ Z7 RCLY and <br />29G 200 WAC. <br />L/ Sipnalw���-�_�� —_ <br />� /� �G�'i // <br />L-12 oZ - 07(� <br />� <br />