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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEOAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 125-257-8857 — www.overettwa.org <br />NPPLICATIONS ARE ACCEPTED fROM 8 AM TO 4 PM <br />G a � - � � z-�, %�,� <br />PROJ[CTADDRESS <br />C�,_e.y c2�;c�t RP,-5 �3a 3-il ��� 5'w i.;�IL �e� r; (uf\ (�oL)aEa -��So <br />Vvmer MaAAd4rese Ciry Stnta2ip � Phorm <br />tenant <br />'.� �R�r"L <br />FIPChIGiI COMfBGtOf <br />Idoil Addrost <br />� 1 N C. <br />Moil AdCre�s <br />/ <br />h'1,2���-��i q�ti DZ � <br />SL�te Lirensa Number <br />Pro(wsed Use ol Bwlding <br />c�ry <br />C�ry � <br />- S�alo(�1►� Phono <br />i �, /�� <br />, ;.s•.A�v � wA (,2� a3o <br />staterzlp Phons <br />�i � �� " Ci l7 <br />Conttact Pncc of Work <br />J�a2�� <br />� ntad Person (Plan Review) <br />Destription ol Work lo Be Oone i� �� I IJ (�j- 1-s7R _.�(z�e..:J.=1_ C��� /� _- <br />C' � �J3 +iU �IS� - . <br />R�� �N � <br />tiOTE� WIRING IN NON-DWEI.I_INGS I5 REOUIRFD TO 1 � CL' <br />B6 IN R�CEWAYS, MC OR AC CABLE <br />CITV OF EVCRETT LOCAL SALES ?AX CODB IS J105 <br />I hom6y crrtdy thrl 1 have rand nnd e�amined fh,s npplicef�on anU Hno�v tnn .nnre fo Ac trve anA <br />rorroct All provisrons olle��s nnd ordmances �oveminy (hrs type of �vo�k ��al� Ac completod <br />�rheMer spenGad hernm a nc! 7hn ryan6ng ol a pmrm( tlons nut pre wmo fo grve eulhontylo <br />rn!�to or [acco� fhc prov��ions ol ony ofhor s7ele or /ocnl lewregu/ahng ronsfn�thon oi fhe <br />pn�imrnnncr af canstiuchon. Thal I en+euthonred by fho o�wo� o/fhis Fmperty fo peAortn the <br />o-nrk Inr u�lnrlr ap��4calron is mnde nnd 1 comFYy vnfh fhe Sfnfe GnntrncYors Lew 7827 RCW and <br />.^9f, 200 N7lC <br />,:•d <br />i <br />._�1 �� f, .,-,, r r,,,, � <br />��noa-r>ae isn: i <br />I (I ��y0o7 <br />PEE <br />35 op , <br />'�NI `�It11�3"13 ANStiIW dSZ�Zi LD DI �QC <br />