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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMlT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 9B201 <br />d25-257-8910 - FAX 425-257-8857 - www.everethva.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�ai1 ��i h 5+, t���,r�k11«JR 9�ao1 <br />PROJECT A�DRESS <br />Ov✓ner <br />Tenant <br />Mail Addross <br />Mail Add:oss <br />City <br />City <br />y��3-`' � <br />L�l(D q �08 <br />?�h�� � 3� y� <br />State2ip Phono <br />State2ip Phono <br />�:O(-L�7 C�u�C��. `d�415 19a.n�Si S�E�mo s wa 9�0��, dcb'll`�-9`ia9_ <br />EleChiCal Contfactof Mail Addross City State2ip Phone <br />NO�Go� �F 17 3QR � \ou,oG <br />Shate Licanse Num6er Con7act Price ot Work , <br />�1; , <br />5ir� �e. m�1�4 Q.cs���cJc� _ - ,; : <br />Pmpose seoiBuilding ContactPerson (PIan�Rav�ew) _ <br />DescriptionofWorkV�BeDone: Mo\I� ('�L�.?�-0.G1'C.- \UC.t>�-i0`(� - <br />,' _. <br />(TF i_• <br />(� -"� <br />�+ t' S <br />,1 ; <br />' : r �_. <br />NOT[: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE .'- `'''-' -_: �- <br />•� <br />BE IN RACEWAYS, MC OR AC CABLE. i; � <br />CITY OF EVERETT L.00AL �ALES TAX CODE IS 3105 <br />1 hereby certi(y lhat ! heva reaJ end exemined this epplicetion ena know tha seme to be We end <br />correct. All provis�ons ollews end ordinencas govemmg this type o/ work will be complefed <br />whetherspeci(ed herein or nof. The grenfing ol e perrriit does not presume to give eufhonty to <br />viola(e orcencel tho �rovisions ol eny othersfete orloco/lew re,quleting constn/ction or tho <br />pedormence o/constr�ction. Thet I em euthonzad by the owner o( fhis property to pedortn fhe <br />work /or which eppliwfion is made end / comply with fhe Stefe Con'roctors Lew 18.27 RC W end <br />296200 WAC. <br />� � <br />L � � <br />�--���(' �'�� ����'-��— 9 -'l -� 1 <br />,���� .��� <br />� <br />