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1 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 96201 <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 ACCEPTEO <br /> ..��v.�.� <br /> 3��f�2c�I-1t�J/�� Sr <br /> �PROJECT ADDRESS <br /> [�/•7/I]/�T /-�/�L}l,tl L`S o�7/7 �.�F2�/IF,e ,�G� FiIE/1E77 c1�ioY�/ �.�i=�7/�- lD <br /> OWnef MailAddress City State/Zip Phone <br />, ��in/n,./C �,�i.i� �m �3d8' b�r�u�iL7F,.d ��V �JF/1Etr ��3 /�'.Z5=�o9-9 7 <br /> z. <br />� Tenanl MailAdAress City S�alelZip Phone <br /> /,�/�mES .=LL�7'21L� pD �QDx /'I9 K�n(la.f l!)A C1�5"1 �.�S-o73S �� <br /> Eledriwl Contractor Mail Address Ciry Staterzip Pnone <br /> /����,y,F_r-n�'�9�/I }3�IU�P ��� <br /> Slate License Number i�I Contrad Price of Work <br /> �,��,.I�S �i R �/-(01" I �m O%,/•9,2A <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: L7��eli /1//Q//�G �� �/[�YY/�C'� � ��Tr/�L�S <br /> NOTE: WIRING IN NON•DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. ��S — <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily that 1 have read and examined Ihis applicafion and know the same lo bo fruo and <br /> correct All provisions ollaws and ordinances govemmg this lype o(work wi/l bo complefed <br /> whefher speci(ed herein or noL The granting o/a pemut does nol presume to give authonty to <br /> vio/afe or cancel fhe provisions ol any other slate or local law regu/ating consWcfion or fhe <br /> peAormanco o/conslruchon. That I am authonzsd by fhe owner ol this propedy fo porform fhe <br /> work/or which ap c 'on is made and I compty wifh the Sfalo Con(ractors Law 1827 RCW and <br /> 296.200 WAC. <br /> I�' // D <br /> Signature Date <br /> �09 i1-08� <br />