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�� <br /> � ' <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 415-257-8810 - FAX 425-257-8857—www.everethva.org <br /> APPLICATIONS ARE.4CCEPTED FROM 8 AM TO 4 PM <br /> ��II U r5 ror� r��.ua _ <br /> �'J' <br /> PROJECT ADDRESS <br /> ;-, , � y��' � <br /> -� _ ;., <br /> ��� ►,�� � �a '�d� I S��`��`�o �1P,� ,(��q�l� asa -���) <br /> Ownof Mail AdGress City Stal✓Zip Phone <br /> n n ���Jr" <br /> � , �I�O � (�J � r� �� �11�• `1�I �SB-J(oCzz <br /> enanl Mail Address City SWle2ip Phono <br /> r r va�- <br /> � Y � � � c� c.�Cl, �)�� EU�r�� j� �9F�3 7rr,-k��S <br /> Electrical Conlra or Mail Address Cily � � State2ip Phone <br /> � L �, ��� . � <br /> Slato Licenso Nu ber CoNr cl Pric o(Work <br /> K ������/� I II�� 1 . <br /> �roposed Uso of�uilding Con ct Person (Plan Roviow) <br /> Descriptionof Workto Be DoneJ iic����� �� �� � �l � '� � ���� ��� l�� �n'����1/lllp ' <br /> 1,�11,'� �}��)U�l��.^� nrll_Ph�- r � l, ); rin�Y `� <br /> J ' <br /> NOTE: WIRING IN NON-DWELLWGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. I <br /> CITY OF EVERETT LOCAL SALES 7AX CODE IS 3105 <br /> 1 hereby cerfily lhat 1 have read and examinod fhis application and know fho seme fo be true and <br /> correct. All provisions o/laws and ordinancos governing th�s typo o/werk will be cumpleted <br /> whether speci(ed herein or noL The granting o(a pem�it does nof rosumo to gi✓e authority to <br /> vrolate or cancel the provisions o�any othor sfato or local law reguPating construction or the <br /> p�rlormance o/construction. That I am authonzed by the owner ol tl�is property to perform the <br /> �vork lo�iich application f made and 1 comply�vifh t�e State Conhacfors Law 18.27 RCW and <br /> 2962C� AC. � ) <br /> !i � � �� /� � i� _ �� <br /> v <br /> ie� Date �7(1 <br /> � <br /> \J <br />