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ELECTRICAL PERMIT APPLICATI�N <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 B AM 70 4 PM <br />''�C4> f���li �"`i �l. J�lT�1�J <br />PROJECTADDRESS <br />3 �ao—og <br />�o �b 3-1v� <br />j 3.. c � 4SZ -'IS'1 <br />�er� l���v.�� y�-\C. ��7C1P 111W4t+�C �R- �ti\AC�f'`:�Jl�l.� �.�R `iQL'!'� <br />OwnBr M�ilAddnx Clly Shte2ip P�ana <br />Tenent <br />Mell Adtlrose <br />Clty <br />St�te2ip Phone <br />kGP.-a'��-! ttEL'fWG f c, �'.�:..i. �24wFf� �'v��u- i.4-t13L ��R `1`C.itc'Z 4u: -'331 - 5'�re:� <br />Electr�calContractor MeiiAtldrosa CMy Sute2ip Phone <br />Fc:�z-���-1�1's1 Ni= <br />Stata L�cense Numbar <br />P�oposed Uee of Building <br />Desaiphon ol Work to Be Done <br />PCt�: <br />NOTE WIRING IN NON-DWELLINGS IS REOUIRED TO <br />�E- IN RACEWAYS, MC OR AC CABLE <br />:ITY OF EVERETi LOCAL SALES TAX CODE IS 7105 <br />� 7�tx7 <br />Contreq Pnce ol Nb�{c <br />(k I�EeQ�� �2� "SLM• -(.`�Tu <br />Con�q Perwn (Plan Ravlew) <br />FEE <br />1 hareby certdy Ihnf 1 hnve raeA xnd e�emmed fhis npp6cehon xnd know fhe senre to ba frue end r p�o3 - I� } <br />correcf All provimons al Inws xnd ordmences govemmg flus type ol wnrk wdl be cnmplefad <br />whafher specAied herern ar not ihe grenbng ol n permR does nofpresume fa grve euthonty to <br />violefe or cenccl thn provisions o! eny ofher slnte or bcel lew regulefmg cons(rucfion or fhe <br />peAormnnca of constnicfion Thef 1 em euthonzed by fhe owner olfh�s property to peAorm fhe <br />work !or wh¢h epplicebon is meda end I comply wRh fhe Sfete Confreclors Lew 18 Y7 RCW end <br />296 200 WAC _ <br />`� — �- ; <br />, ,� , .� - <br />�__ � <br />-�ynatw ` <br />�� , <br />