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� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX42S257-8857—wwvi.everettwa.org <br /> APPLICATIONS ARE-ACCEPTED FROM 8 AM TO 4 PM <br /> 7 '7, `i uPPr' 1� {L� DCrc ROA � Lot� 1 <br /> PROJECT ADDRESS <br /> �'� I� f�' u�-tPti iRYi(7 �8'tiA� r.� s� � roz. L „�,+c��U c�-9�qa0.?h yzti-»3-9ssy <br /> Owner MallAddross Ciry Sbte2ip Phone <br /> Tenant MailAddreu Ciry Sfato2iD Phone <br /> i <br /> �Pr�' N (' IP � �: c I (i. 'ir�x 12GGR �,;f'l� L,�erK W/� i�.u0.�'� yZs` su.P-c�Y7,� <br /> Elet7icalCOnbacWf MailAddress Ciy Stnto2ip Phone <br /> Ferr� � r C1GG ��1� '�.50 0� <br /> State License Number Contract Pnce of Work <br /> A IAn� �C'f;� ,J <br /> Praposed Use oi Building Cont+ct Person (PWn Review) <br /> Descnption of Work to Be Done: ��._!�I �'1' �U�� G� , <br /> NOTE: WIRING IN NON-DWELLINGS IS RE��IRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE 151105 <br /> I he�eby ceRily thet I heve reed end ezemined fbis epplicetion end know Ihe sertw ro be frva end <br /> wrrect. Ail provisions ollews end ordinences povemmg fhAs type o!krork will be completed <br /> �sheLherspec�ea heiein or not. The grenling o)e pemrd doos not presume to give eufhonty fo <br /> violete or concel the P/ovisions of eny ofher stefe orlocel lew raguleting construcfion or the <br /> peAormence ol�nstrudion. Thef I em nuthonzed by fhe owner o/fhis property fo peAorm fhe <br /> worN lor wh�ch epplicetion is mede end I compty wrth the Sfefe Confredors Lew 78.27 RCW end <br /> 29b200 WAC. <br /> L_��i� Q �� � _ � • L�� <br /> Sipnaturo Dato <br /> Fd�oOl-D7°I <br />