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�� C <br /> � _� . � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SER`�!�ES <br /> 320� CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.evereriwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> ��U� P'r��'t ��� �a— <br /> PROJECT ADDRESS <br /> Owner Mail Address City State/Zip Nh�+�� <br /> Svto lsleSlcill en+e�/ �CD! /.�rv�od�-R�+� �ie���f �c/%� 98�3�/ — <br /> Tenant Mail Address Ciry State/Zip Phone <br /> � �I i J DFfY� (5�.2>l�L�7)1h1Ul�CC�I?a:�r'�onc�IZcl Gt1CDe�rnv�l�2 GJlF1 ��lZ �/1S(o��(o � <br /> EleCtrical ContraCtor Mail Atldress Cily State/Zip Phme <br /> D�OFPR�-�'� S ��Z- 1 / ��L�D• � <br /> State License Number �ontract Price of Work <br /> ' }' D1L!(i� D�� <br /> Proposed Use of Building Contact Person (Plan Re iew) <br /> Description of Work to Be Done: I�-7TQI T � ���I��� 'Tt7V ,r����T�m V ����1`-^ � ' <br /> f-le�� ���if� �7���r�c wi�// � i�str�(l' ��re5i SSq// I/�vnoKR/) <br /> ��e S�����s r�� 9�2�� �� ��c�5 - <br /> hOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. � <br /> CITY OP EVERETT LOCAL SALES TAX CODE IS 3105 1�a .. � . <br /> I hereby certify that 1 have read and examined tl�is application and know the same to be true and � � <br /> correct All provisions o/laws and ordinances govemmg th�s type of work wdll be completed � <br /> whether specifred heiein o�not. The granting of a permit does not presume to give authonty to <br /> violate oi cancel the provisions of any other state or locallaw regulating pconstruction or the nD! ' � <br /> P o�k for whc h applrcatio�l s ade and I comply with fhe Sf te Cont actorsPLaw 18.27rtRCW and ���/ � , . <br /> 296.200 WAC. � <br /> ��--y� �C� lv '��'/� <br /> Signature Date <br /> I <br />