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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 ; fl(�j <br /> 425-257-8810 - FAX 425257-88�7—www.everettwa.org I�� � ` <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM ( �����D�� <br /> lS� 2�7 UPPLf� R��P f10,a � Ln{- '� <br /> PROJECT ADDRESS � <br /> �>� �-�G�r�S � � �{I (.� 2.� �� /1YL W SJ � �U�L �vvUwt!'ct Wr�S�Uib �l<S'71S-95Sy <br /> Ownar Mail Addrosa Ciy � Stale2ip Phona <br /> Tenant MeilACdwaa Clry StatolZip Poono <br /> 4-B � ti7 L �C 1r� l U� ��'�� �Z �h.� /7j. �1 �rPrk b�4��QO4Z 425'4!),Q'U4741 <br /> ElectriCal Canl7actof Mail Addross Ciry � State2ip Phone <br /> �C.rr, r r�L6A1L �:150�6�� <br /> State Licenso Number Contract Price of Wor!c <br /> /'I�A nJ �t'�' ��tI <br /> Proposed Uso ol8uilding Contact Person (Plan Reviaw) <br /> Doscriphon o}Work to 8e Done: �l,^� E� �P �J� C� <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br /> I here6y certiy fhef 1 heve reed end exemined fhis eppliceGon end know tho seme fo be true end ' ���' �� ( ����� <br /> correct. AN provisions ollews end ordinencos govomm�fhis typo oI urork will be complefed <br /> �vheth,erspac�ed herem ornoL The granfing a!e permrt does not rvwme to give euthonty fa <br /> violefe or cencel the prvvisrons ol eny othorstefe orlacellew reguPt�ng mns7ruchon orthe <br /> podormenco o/cansin2fion. Thet 1 em eufhonzod by fhe owner o/this property to peAortn fhe <br /> work lor which npplication is mede end 1 mmply wdh the Stefe Contredors Lew 7827 RCW end <br /> 296 200 N!AC_. <br /> � ! 'c,�,l�- � -� L�(�; <br /> Sipnaturo Dato <br />