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ELECTRICAL PERNIIT /�PIPLICATIQN <br /> CITY OF EVERE77 PERMIT SERVICES <br /> 3200 CEDAR STREFT, EVERETT, WA 98201 <br /> 42�257-8E310 - fAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> l��� l � i2�� �� Sj la� �� <br /> PROJECT ADDRESS <br /> L����' 2 � � � .� a�� � �� / � � g��� <br /> Ovmer hbil Add�csa Ciry Sl Phono <br /> �lY V <br /> Tenant MailAGtln3ss CRy SlPtC2ip Phune <br /> �i'��s���i���r�ir%�2�.s��r'�i����� ����l�—��v��� �z <br /> �10CVIC81CofiVflClOf MailAdd�v.5s Qry � $�nta/Zip FhorK <br /> P�eG �ee 9�yG � �2�0 I� <br /> tate Licensa Number Cwitrad Price of Work <br /> lV.� w ly�9/e ���1� C�i ��r� 1�'��/,�%Dt� <br /> Proposca Use of B� ild' 9 Coo�a,c Person (Plan Review) <br /> v <br /> Squard Foolage(If residen6ai new cpnsWction,remodel or addition) <br /> Oesviptlon of Work to f3e�one: _ �-�,Il`}j ��Q�R _ <br /> T �— G�\ — �� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN R.4CEWAYS, MC OR qC CAB�E. <br /> � �'�) --- <br /> GITY OF EVERET7 LOCAL SALES'(AX CODE IS 3105 <br /> f horuGy cortiry Uiru I have read and examinaa thrs application and know U�a sama to be wa pnd <br /> cc�rrgc(. AI!pmvlsiwrs of faws and o�T/inances goveming this rypo olwwk wdl bp.a7rrrpleted <br /> whefhor sp�cdraQ Aarcin or not. n�e granting Of a permR�oes not yn:.sumg to grve authority fo <br /> viplate or cancel fhe provisrwu of ony oBier stnte orlocal law rogu/a6ng construcGbn or the <br /> por/orm�nco of con�t�ucBon. Tha�I am authonzed by B�e owner o(Nfs propeRy[o pod�M11(he <br /> wo.k for which Applica6�on is mado pnd I comp/y witlr tho SYate ConUec(Ns l.aw 1 B.27 RCW gnd <br /> 29fi. 00 WAC. <br /> 2 2� <br /> ignuNre Dal <br />