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ELECTRICAL P�RMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everellwa.org <br />A?PLICATIONS ARE ACCEPTEO FROM 8 AM'f0 4 PM <br />�����' So�c�Z) ��`�I ��% <br />k� �., <br />PROJECT ADDRESS <br />3 �� s --i o <br />Cioo3-v7� <br />�iL�..� , s f 3 D � �6» �, � �,, /� � � (� ��, o �`�-� -�� <br />OWuer A1ail Address City Slale/Zip Phonc <br />�3 � o S� � �a �'� <br />Tenanl <br />M17ail Address <br />Cily <br />Slale/Zip <br />Phonc <br />�'L,^� s����f, �_ 73/ 2s��i s�'- �v� ✓ s�,1L�����✓� �r��rz <br />[ledrical Conlraclor A1aii Addwss Cdy Sta�e2ip �� Phone <br />�'l«�-,� r-to �r�y <br />Slale License Nwnbcr <br />Proposed Use of Building <br />Descriplion of Work lo �e Done: �L./ � <br />NOTE: WIRING IN NON-DWELLINr,S IS REQUIRED TO <br />BE W RACEWAYS, �dC OR.4C CADLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 31J5 <br />� 1aa oG 'f u' J�� q�-,� <br />cor,a /t Price of Work <br />Canlact.Person (Plan Revic�s) <br />1 heroby certily (It�t 1 fmre r�ad anA examinedlhis application . nJ Ano�r Iho sarne fo 6o frue and <br />cunect. All provisions o/lau�s and on/inances govemmg tlus type o( �rork �rill bo complefed <br />�shrther spocJicAhemin ornoL The pranfing e/a pernuf does not :reswne to gi��e ovfhonty fo <br />violaf� or cnncel fhc provisiens of any ofher sfafe or local latv rec�u�nfi,ig consUucfion cr fhe <br />performance oI conslrucfion. Tha( 1 anr aufhorized by (he o�rner o/ (his propeny fo peAonn fhe <br />�io�k Por which application is mude and 1 cornply �vifh the Sfatc Ccnh.vcfors Larv it3.27 RClYand <br />29G,200 WAC. <br />� —�S� 2�'�� <br />L 9c���°� <br />F[[ <br />`LI CD3 - 4'��f <br />