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( _ <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES S.`��Z <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org � I� S ^/�} <br /> ��� � <br /> APPLICATIONS ARE ACCEPTED FROM 8�1M TO 4 PM <br /> 1`�G��l �ro2 �c��ay <br /> PROJECT ADDRESS <br /> �3� <br /> �r � � � —`�3( <br /> -�i'lU/i�/!c i 5 1�Gt�'ys ct� /� � �``�J - <br /> O�Nner <br /> MallAddress City Slate/Zip Phone <br /> Te i� C � Slale2iP <br /> � � Mail Address Ciry �ya� Phone <br /> � )m �.p �/`` }yn c 1�3c�G s�s�Jl9/�/�►'��y�T ►T/r���� �39—��G <br /> / /"1 �V l��� ✓`�N�-- 1 Ph <br /> ectrical Contractor Mail Address City ��d�c� N <br /> 1�//1 � /�'0�.� ��"��� �3 Zoo�,� <br /> State Lice se mber Contract Prico ot Work <br /> Ct` d�'i e�'f �Lt�l �P�J� � Contact Person (Pian Review) <br /> Proposed Use of Building <br /> / � r 1 ( ,� <br /> Description of Work to 6o Dono: ` < < � �� � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO �E <br /> BE IN RACEWAYS, MC OR AC CABLE. I 3� sv <br /> CITY OF EVEREiT LOCAL SALES TAX CODE IS 3105 q <br /> I hereby ceriify that I havo road and examined fhfs applica�ion and know fhe samo to be true and � I Z � �—' � I I <br /> conect. All provislons o/la�vs and ordinances govoming fhls type o(work will6e compfeted <br /> whefher specified herein or noL Tho granting o/a pemut doos nof presume fo give aufhonry to <br /> viola(e or cancel the provisions ofany otherstate or local lnw regulatin g construction or tho <br /> performance of constivction. Thaf 1 am authonzed 6y the owner o/this propedy to pedorm the _ <br /> —work�lor-whicA-epplicefion ismade end l comply wf��rthe-S1eteGonfrac(ors L�ew-1837-RGW-end <br /> 29G.200 WAC. <br /> ' " � �(/''��___�iZ� ��� `� <br /> gnaWre Date <br />