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l � <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 U�U ����f]�p`� <br /> U �/ � <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM /j <br /> � <br /> _ .���7.5 �un ���vt LI�F'i E'�Ps� En �ITY OF EVFREI'j ..... <br /> ,r� � � 9�neering/Public Serv <br /> PRi�JECT ADDRESS e� <br /> E'n 7`e��i s� ����c,�o- ,S�Sdf�v��rr,�i� [�/c! �'����� ��f- y/�- 7.S'Z<S <br /> Owner Mail Address City Stale/Zip Phone <br /> J�.-.'/ `� <br /> Tenanl PAailAddress Cily Slate2ip Phone <br /> ��/��n.-7Lsar Ss%. Se�[/�/-� �2c�'r-/zj..�/f�E �r�o.�rv l� zs3-5�'3-arsz <br /> � <br /> EledfiC21 ConitaClor Mail Address Ciry Slate2ip Phone <br /> CulJ3Ess ys� �-f c! rK� ���ia 3So. ������«.�K.<%�t� <br /> State License Number Contract Price of Work <br /> � .Ci3i 7�'!/ J �ot/r'! �En"�J <br /> Proposed Use o/Building Contacl Person (Plan Review) <br /> Descnption of Work to Be Done: J`"L��<�� /1 E� �� ��",�lt - <br /> � � . <br /> Si�.'—' �'prin%� '� .S�$��(, •–fSIJ� <br /> �. <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> ��.(�� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 .�^O� _ �.�,^�• <br /> / Y..I <br /> 1 hereby cedify that I have�ead and examined fhis application and know Ihe same to 6e Irue and �/ � lJ� <br /> c�orrect. All provisions o(laws and ordinances governing fhis rype o/work will be complofed <br /> whether speci(ed herein ornoL The granling of a pemuf does nof presume to give authonty fo <br /> violato orcancel Ihe provisions o(any ofher state orlocal law regu/ating constroction or Ihe <br /> peAormanco of construction. That I am aufhonzed by tlie owner ol(his property fo perform Ihe <br /> work lor which application is made and 1 comply with the Sfate Contractors Law 1827 RCW and <br /> 296.200 WAC. / <br /> � � .Olrrl� � /l` ��/ <br /> �naWre —� ' Dat <br />