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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERF_�T PERMIT SERVICES <br /> 3200 CEDAR 3TR�.:�, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 –�vww.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> l�c��r' li�-,ac�c�� . Sr.�'A /_-��v ����icJQ, <br /> �ROJECTADDRESS <br /> � , �"" � �'� /e C.�,S�. l�`>l'Z <br /> ,��� � ✓ �a � � ��//G> 1 !5 L ,v � 11 <br /> Owne� MailAddrass City Stale/Zip Phone <br /> J` /� <br /> Tenant MailAddress Clry Stale2ip ) Phono <br /> L+� 7 <br /> ,��� ���' `�}1iC�� j � ��� "�U��� � �C�'1'�r✓1sf�� �Jft �!�� � � �'7���� <br /> EleclricalContraclor MailAddress Clly Stale/Zip Phone <br /> �.j� � � �.� ��� r � z ��/q/�z � 2� <br /> Stale License Number Contract Price of Work <br /> �'� ���� �� ritio,�—��-�" ��.�i.cll Er'' <br /> Proposed Uso of Duilding Conlacl Person (Plan Review) <br /> Description of Work io I3o Dono: ,�_,/�� 1/• C�.�rS �' �-�0 U �^��S <br /> _ � <br /> � - i�t. 6 r^ . <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. '' <br /> / Lj�,� . <br /> CITY OF EVERETT LOCAL SALES TN(CODE IS 3105 <br /> 1 hereby certi(y Ihaf 1 have read and examined fhis applicafion and know Ihe samo to be frue and <br /> correct. All provisions of la�vs and or�dinances govemmg Ih�s t}�po oI work iti�ill be complefed ���� �, <br /> �rhether speci(ied herein er noL The yranting o/a pernuf does nof��resunm to givo authonry ro <br /> violate or cancel t0oI�rovisions o(any othersfato or localla�v regu ating cor�struction or Ihe <br /> perforrnance o(construction. That I am aufhonzed by the ownerolihis properiy fo peAorrn the <br /> work(or�ahich application is ntade and I compty with tho Stafe Conhacters Law 18.27 RCV/and <br /> 29G.200 WAC. <br /> i�-�-�.-t�l �i ��/— �' �,�L- ,�O// <br /> —' Sign ur� Date <br /> ��iZS� z(��- 77��,, <br />