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( <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX425-257-8857—www.everettwa.org <br /> APPLICAT10N3 ARE ACCEPTED FROM 8 AM TO�PM <br /> >� - •�� �,�7�7L�iu�. �v�. rl� �,./r�. ��..zD/-0000 <br /> PROJECTADDRE.E <br /> ,� / ���.� .zs-.z-�5�a <br /> �h�t i SJ�of9� ��i�/c��J/ �P C' �'�1JC" .�7E� 7 Co�bk �ue S�te /.2C�� �ue': .7� !✓ <br /> Owner Mail Address Ciy � Stale2lp Phone <br /> Tenent Mall AAdress Cily S�ate2ip Phone <br /> /¢— , 'rrl� f�y� S— �'/ I C'I`� T J '.ea!//N Lc�JT ��/J�/�L>G�G�.2�':2k�i� <br /> Ele cal Conhador Ma�l nddress Ciry State2q Phone <br /> /�i�1c'>t/UT'�-ELD0.7'�'i <br /> StaM License Number Contrad Pnce of Work <br /> �v�'�� ,�x,��'2 <br /> Proposed Use of Building Contad Person (Plan Review) <br /> Description of Work to Be Done. Sa� /s �� C�r � 14'�C PS < Cc> > /i c /Ds+ �B / <br /> / � ) i <br /> L 'C / !/ri /�.F cf�P — <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 3106 <br /> I hereby certily Ihat 1 have iead and examined fhis applicafion and know the sama to be frue and <br /> conecl. All piovisions o/laws and ordinances goveming this type of work will be completed <br /> ��hefher spealied herein or noL The granfing ol a permd does not piasume fo give authonty fo <br /> hu�afe or cancel the provisiais ol any other stafe or local law regulating cronsfruction or the <br /> pen�rmance ol cvnsfruction. Thaf I am aulhonzed by the owner o/fhis property to perform fhe <br /> work�or which applicafion is made and 1 cnmpty w' e State Contracrors Law 18.27 RCW and <br /> 296200 WAC. <br /> � <br /> : o �� ��`.��— � <br /> `Signalure Dale � �� <br /> i � � � � <br /> :� j <br />