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II �'U 901� 1i:1:1 P:l\ 4'1Ci1157H^ 1':\IiSI':I.I. lil.l':C'1'NIC <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STRF.ET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everetlwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� 9 tr q�t" p� SvJ <br />PROJECT ADDRESS <br />Mall Adtlres� <br />Clty <br />Stele2lp <br />�oo�t ooa <br />c: iz/.-i� v <br />I/-��`�Z <br />yzs 4zz [688 <br />Phone <br />Tonenl Mall AdOroes Clty SUte2ip Phone <br />Ye.s� 73s ��oo <br />` � <br />.�,�,4w/LLL Ey,4s; ruC. ..1_n1[. 40�5 c2 92_ 1w�cF C;tvENS ll�l. �(8LSA <br />[IncMcal Con�ractor Mall Atldreas City Stale/Zip Phons <br />�L�r E6 r Ql � i3 M v <br />State Lic�nse Number <br />_sFrL CIc�����d�1 <br />f'ropoaed Use o( Bullding <br />Descdpllon ol Work to Be Done <br />_ A1EW GNS%2JLIIOIJ <br />NOTE: WIRING IN NON•DWELLINGS IS REQUIRED TO <br />DE IN RACEWAYS, MC OR AC CABL[ <br />CITY OF EVERETT LOCAL SALE9 tAX CODE IS �105 <br />_,��ZOU o0 <br />ConVacl Pdce of Work <br />Conlect Pe�son (Plan Revlew) <br />FEF_ <br />��ev <br />y cortily firaf I hevo iead end exemined thls eppllcallon end know the seme to be fnio and r�� .I � I�, / <br />A/ provlsions ol lews end ordinences poveminp flus tyFa o! work wlll be compleled C ` j <br />r speclfiad hoieln o� not The grunOng ol a perm7t does not rasume to glve euthorlty fo <br />or cancel fnfl provisions o! erry ufhai stete or locel lew reguPf�ng ronsfruchun or fhe <br />ience ol conslruction T I em eutho�ized by the mtirrer o/lhis property to peAom� fhe <br />r whir.h epp6cxGvn is n de nd 1 comply� wrth fhe Sfete Contrectors Lew iD 27 RCIti and <br />