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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 - FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> +(_�7S � �n �..iL�T� s-\J�. <br /> PROJECT ADDRESS 4 z� z.s y u5� <br /> �j-�r.Ut: � �� Sr!� �ut�Z ��n �L IL.�7 L�•.,cl�c� M/t� rVI�L%i � w� �IVZvI <br /> Owner Mail Address City Stale2ip Phone <br /> S Ary�C /1S �Q�✓,� <br /> Tenant Mail Addiess C1ty Slale2ip Phone <br /> (6s> <br /> �_A'�e`! �-l�n�'Zi /�� �J7( ,Q�tt,9pOr;Ve. IVN�-�C' �El4��C- lh�C� �ni✓ 'J7/IO 4ZG-4817 <br /> Eleclrical Contractor h�ail�ddress City SIare�Zin Phone <br /> State License Number Contract Price of Work <br /> �ES�i D1.ovc�- nos�e5���AJ� <br /> Proposed Use ot Building Contact Person (Plan Review) <br /> r�rL ��D ���P. P�,.,,�e�2 pa�e.: �Q A90,-riu�., • �u�l <br /> Descnption oi Work to Be Done� J <br /> �,.�i2C 14�v(� A,�Qr'r�uNaZ Cic'cur i 6u� I=o2 N�-v AOD� ��o,.� r�0 <br /> (;�Sr ��iu,r�•�YL �s" oX /�S r4 suB - Pf++��Z � <br /> NOTE WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RA�EWAYS, MC OR AC CABL[. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby cerVly tNat 1 have read and eaamined this application and knoir Ihe same to Ge true and <br /> correcf. All piovisions o(laws and ordmances govemmg Ihis type o/n�o�k will be completed <br /> �vhe(her sPecilied herein or noL The granfing ol a pem�d does nof presume to give aufhonty to <br /> violate or cancel fhe provisions o/any other sfate or local la�v regulating construction or the <br /> perfonnance o/consln�cLon. ?hat 1 arn authorized hy the owner o/this property fo pedo.mi the <br /> �vork for which app6cation is m de.r d I corn y�rdh fhe Sfate Conhacfors La�v 78.27 RCW and <br /> 296 NAC. <br /> ���� , <br /> G- ll- D ?G�- �� <br /> Signatu�c Dalc � <br />