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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT �ERVICES <br />3200 CEDAR STREET, EVEHETT, WA 98201 q`�r� ` u <br />425-257-8810 - FAX 425-257-6857 - www.everethva.org I �5 <br />Ci�a�-r�c� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />/ " <br />�`' � %1� �, < <br />� ,' > >T <br />PROJECT ADDRESS <br />�-� � i � /� � ' � <br />4 � <br />/ `/� 71 i�' , <br />. , � �,� <br />� �`C L� � L� � <br />�,:��(�`7C�(� �'��i�-,i'�na/illil"> �— <br />Ownor Mail Addross Clly Slate/Zip Plio�e <br />Ten;�nl <br />�, <br />tt;i ��.i l. l� _ �i �� <br />E�octrical Conlracbr <br />Sla�o Llronso Number <br />Proposed Usr. o� Dulldinp <br />h7ail Addruss ���Y <br />�o l�on l`73< �^1_„ <br />Atail Address ����/ ` <br />Slate/Zip <br />, /�- __ cJ„ <br />s�:,i���a�i� <br />Dcsr.riptinn ol Work to �o Dono: �(� /i L� C�L__— ---- - <br />� <br />NOTE: WIRING IN NON-DW[LLINGS IS RE�UIRED TO <br />B[ IN RACEWAYS, A4C OR AC CABL[. <br />CITY OF [VERETT LOCAL SALES TAX CODE IS 3105 <br />Phono <br />'1P Z 7G <br />�'none <br />Gonlrar,l Prir.e ol Wor4�. <br />� <br />�lt� ����/�1r•irJ�'�1 -- <br />Conlar.t Person (Plan Review) <br />1 heroby certity tlr.if I ha� c �ued nnJ examinrd this applicafion unA hno�v tho same lo he Ouo and <br />correcf. All provislnrrs o! Imvs and oidinrricas qoveminc� �hls (ype o! �rork �ti�ill bo completod <br />n�hefher spocihed hive.in or noL ihe pinnfinc� o! a perrnd dues nof �resume to �i���r nuUvnly to <br />violate or cnncel the provlsions o! �3ny ofher sf�te er local l��w re�ul�ling consfrucfion cr fhe <br />performance o/ consirucfion. 17wf 1 mm �ufhoiized b}� tho o�vne� o/ fhis property fo perfonn fho <br />work (ar u�hich r�PPlicnfion is mnde and 1 wmUty �vifh the Stafe Confratfors Lorv 18.27 Rl. W and <br />79G200 INAC. � <br />, � , <br />; �, ; �; /z �� /r � <br />, �, , „ _ _ �. � _ _ _- _ _--- ' <br />— :s���,.�n���, u,i� <br />FEE <br />, q-I��- <br />� iiU <br />