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� - <br /> � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAF. STREET, EVERETT. WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ; ° <br /> �j /� �(�� i <br /> ��'��/`� Yi..57� [/.�.J.>rt �!� <br /> PROJECT ADDRE55 <br /> O�g� Mell Address CIIY Slxla/Zip PMne <br /> .C��' /i�,/.�,�. � S�L��JGc./�� ''G'' "-3�"yr'z <br /> Tenan� Mail Address CBY SlalelZip Phone <br /> ��, %l-:l,7r-1 /l.f�j� ;�r � - F/.�.,..' /;;_ i;y r r.r z�� �.,k. <br /> /i .0 _ <br /> E�edrical Coniraclor Mall Address �nY S�eieiZ�P Ph°"° <br /> r <br /> /`"�/�'Ar�":�� 1iG r' '�`, ._. <br /> State Licenae Number Conlrad Price of Work <br /> X;.•:/i <br /> ; � �i�/� S/jft'.E //<;.)i�" .✓ <br /> Proposed Use ol Bwlding ontad Person (Plen Rewew) <br /> ,- , r, <br /> _ / � �/ ' <br /> Descnpllon ol Work to Be Done /^�1'"Z <�/��t., ,/n� '7'ii � �t'i��j,�,.it -t:�e� <br /> � <br /> lj��l�-^ �v I.. <br /> NOTE: WIRING IN NON-DWELLINGS IS REOUIRED TO �E <br /> BE IN RACEV�'AYS, MC OR AC CABLE. <br /> CITV OF EVERETT LOCAL SALES TAX CODE IS J106 <br /> I IremAy cro�6ly fhal 1 f�nve rAad and n�enunaA lh�s applicatron nnd know fhe sarnx lo ho Inie arrd fl I r'�1�i _ I-�" � <br /> r.ormcf All pmvrsions ollaws arrAoRLnnnces qovenung this type uf work xvll he conrpleted (/l/ � LJa <br /> whnlher s�incifind hnmrn or not The pran(ur9 0!a pe�md Aoes not >msunre fo gim autl�unty fo . — <br /> n <br /> siolafe n� uincel fhe provisions o(any olhe�slafx o�Iceal law mgu ahng mnsbucfron or the <br /> perforrnarrco ol cronsfruchon Thal I am aufhonzed by fhe owne�n/th�s P�nlx'ity fo pe�form tlre <br /> work lor wh�cn np{�l�cabon is nre0n�nd 1 comply wdh flro Sfato Confrar.fors Lnw 18?7 RCW and <br /> 296 700 WAC. � <br /> _ , //i�"y- / �S/-,�"/. <br /> Slgnalure a�e <br />