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ELECTRICAL PERMIT APPLICATION j <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 B AM TO 4 PM <br /> � �� � � "� � <br /> �-^ '�' //�� �9 /� r GU l <br /> l-7� J / �� l �i� L" � ��C � f r� !/'- � � <br /> PROJECTADDRESS � ��� <br /> � <br /> .�J � � � <br /> ���� �� ��c-r �i.�J� �/s� ����' ;�'� /�;�✓' , s !�'�� %i�l�� E <br /> Ownor Mall Addmss City Stale/Zip Phone <br /> Tenanl Mall Address Clly Slale/Zlp Phono <br /> ,'� / —/- <br /> „�I.�.Cr� („/,� r �/�� /f;� r�a d��.�' ;� �/ ��,�/� �:/a- 1� "� �� � <br /> Elo�lrir,al Conlract r Mall Address � Clly Slate/Zip Phone <br /> v �� a��'�5 % S—�P �/ <br /> ���7n�� (^,�� 7C �% � / �� / � �, ��li /� <br /> Si.. � Licenso Number �— � �t-� -�� Conlract Price of Work <br /> i / I , . 7 <br /> I /� � ;'r� i' . . � �� " <br /> Prop sed Use of Building Contact Porson (Plan Review� <br /> � : ," i f <br /> Description ol Work to Oc Done: �'�',: ��' ��� `��, i ,• / %� [� � i l � /�� > /7 <br /> � � �� <br /> l� L'1/ , ; '�• ��/ '���� �'�> �ri f- <' _ <br /> � <br /> NOTE: WIRING IN NON-DWE�LINGS IS REDUIRED TO FEE <br /> �E IN RAC:EWAYS, MC OR AC CABLE. <br />� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> 1 haoby certdy Ihnl l ha��e read end exnrninnAfhis applicnfion end know the sarne fo be Vuo and <br /> corrocl. All provisions o!lews enA orAinances goveming fhis t}�pe o!work will be completed <br /> whefher speciGed herein or nol. The grnnfing ol a pnrnut does nof nosume fu give authonty fo <br /> violnfo or cancel fhe p�ovisions ol eny offuv sfefe or locel law regulating construcfion or fhe <br /> perforrn�nce o/con�trucfion. Thof 1 arn aufhorized Gy the ownor o/fhis propeny to peAonn fhe <br /> work lor which applicafion is m•,ie nnAl comply with fho Sfafe Contractors Lmv 18.27 RCW'and <br /> 29G.200 WAC. <br /> — --�'�� - i " —— ; (�/ ',j'���� <br /> S¢ina�ure=���� Dale � <br /> � <br /> .-l�V'� .. �' �: <br /> l <br />