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• ( i <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org <br /> APPUCATI!�NS ARE ACCEPTED FROM 8 AM TO 4 PM �- o� �� <br /> � �Z� y..O�tJ <br /> `� � I �j _F„ e rry!e v.-� Wy. <br /> PROJECT ADDRESS <br /> �s ti cQ a f C_�r� e � �O e.t ca��'/ �,5oe . !a� �� cc�.a S-F 5te z10 Sec�l('3 C,�74 `7�'l0 <br /> Owner Mail Addross Cily State/Zip Phone <br /> � �� <br /> Tenant Mait Address City State/Zlp Phone <br /> Se�,�� �l�e ��`v-;� -? ost� s zzo� st � w�t . 5Po 3 z <br /> ElectdcalCo��tracto� MailAddress City State/Ztp Phone <br /> ,�paO .OU <br /> Slate License Num;�er Contrect Price of Work <br /> Proposed Use of Building Contact Person (Plan Revfew) <br /> DescripUonofWarktoBeDone: �iXfJ'if-� � ^ � ��'•'�v`� � � 2 �' - OFS(� e 'fviz wvT �� <br /> � <br /> ��� r� h� � t���k <<� �x-,���, ��9 �s�� u � �( ��,Q�q�.� <br /> c%r,n,�c.�-�,;,�.� -��r �o-z� �- . .1� (.�,-u, l/�I-�«r,e h�f�o� cl,�.l�s ���.�i, <br /> � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � a�� ^ U�� <br /> 1 hereby certi(y thaf 1 have read and examined this appllcatlon and know the same to be true end <br /> correct. All prov(s(ons o(/aws and ardlnances goveming thls type of work will be completed <br /> whefher specified he��in or not. The granling of a permit does not presume fo glve aufhoriry to <br /> vfola(e or cancel the provisions of any other sta(e or loca l law regWa ting cons truc f lon or t he <br /> performance of construction. That!am authonzed by the ov-ner of fhls property to pedorm the <br /> -—work-/or-whiolreppllcaliondsmade-end-Fcomply-wilh•fhe-Stafe6onfrac(orst•e�wI8:2FR8W an <br /> 296.200 WAC. <br /> L�/Q � �� �- Z�- I7i <br /> Signature Dale . <br />