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I <br /> � <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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> J 5 �S ��1�' Q'�-Q,P�1 � <br /> PROJECT ADDRESS � <br /> ��25 -y?8 - <br /> ; ,Cj���1� �sr(� � Loi 30 l�Vlcc..�-I��� 12�,�, !,(�aods�u��LC� ��c�14 �q<<y <br /> Owner Mail Address Cily State/Zip Phone <br /> �I2S " '7I0 - <br /> �1r�e��iw� �s,1��5�� 5�50� L�v-zv�ree.�, l.<-�uu �=v-�.�cJcJf1 �s,� <br /> Tenanl Mail Address City State/Zip Phone <br /> I ` Q ,, p NS�S <br /> ��- �-"� t-1ti_V�S r��U� �.Q 13 n �/,l,�,'�-l;-c�{� �r� �L�C7C�cl t.vi v i ��,Lt'{� c�7Y� r9y`t <br /> EleCtricai CoNraClor Mail Address City 11 Slate2ip Phone <br /> `4����0 ��O <br /> Slate License Number Contract Price of Work <br /> �-1�-�� � C�G�(�/ (��C� ir..jC I Vwr� ��CIJC-V`t `I` <br /> Pro osed Useof Buildin Conlact Person (Plan Reriew) �ZS"3oY- <br /> � � �� I? I <br /> ) I ( i <br /> Descriplion of Work lo Be Done: �(� � L� /c�,V � ���.� l l G-'\ L.r/LG � U /�t U <br /> �� � L� t� �c�r( < < L_.c�c� r-�L <br /> 1 <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 <br /> 1 hereby ceriify fhat 1 have read and examined fhis application and kno�v fhe same fo be true and <br /> correcL All provisions of la�vs and ordinances�ovemmg this rype o!work will be complefed <br /> �vhether specdied herein or noL The granfing o/a permrt does nof presume to pive authonty lo <br /> violate or cancel the provisions of any olher state or local law regulating construction or the <br /> perfonnance o/construchon. That 1 am aufhorized by fiie o�anero(this property fo peAorm the <br /> wo�k!or which application is made and 1 comply wifh the Stafe Contractors La�v 18.27 RCW and <br /> [96.200 WAC. <br /> C�� , . . ._. . _ <br /> �--- 1 � 1a - � � <br /> SignaWre Dato �/� <br /> nhli l <br /> �,�J <br />