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� <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 - DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> � b I , A `� r o A p� vJ o. �/ <br /> PROJECT ADDRESS � <br /> p ` 415- <br /> Vv�a�- l�, �c.i„^ 1 81 S A t� ,�oo�dw� Y ��+Yt.� w/L 9 �Lo1 Qlt� �-f Q/,1 <br /> r <br /> Owner Mail Address Ciry State2ip P�one <br /> 1� « �1 <br /> a� �� �� � t <br /> Tenant t.lail P.ddress Ciry S'.�ieRip Phone <br /> C 4i1� <br /> -L4� ��.�. h-t l�� c�� r.0 �-i..t _ St..o�..o�n.., 5�.. wA �IPL�C 19F - 9261 <br /> Electrical Contractor Mail Address City State�Zip Phone <br /> Z�.. l......e �� d1�SA � S� �ioO� �O <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Pian Review) <br /> Description of Work to Be Done: A r� c� � v q � w� L� �� �q�4 f A a a �L���w <br /> �C�U �� �^�.. �t'i] ' �e— � v�n ,�• T t_�t v� Y O L n d 'L \`J�'��,q v�� � <br /> C � t- L �n.� r Y�A h n e L . � L v, '4�� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED 70 FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> !hereby ceRity that/have�ead and examined this application and know th,e same to be tn�e and <br /> correct. All provisions o/laws and ordinances governing this type ol work will be completed <br /> whether speci6ed herein or noL The granting of a permd does not presume to give aufhodty to <br /> violafe or cancel the provisions ol any other state or local law regu/eting construcfion or the <br /> peAormance ol construc6on. That/am authonzed by the owner ol th�s prooeRy to pedorm the <br /> work for which application is mads and I compty with the Sfate Contractors Law 1fl�7 RCW and <br /> 296.200 WAC. <br /> ��_ � ti- L^� �o�l <br /> Signature �ate <br /> E d�.��-�'H <br />