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( <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.everetlwa.org <br /> ��-a8-�v <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ['�p�Z�7(/ <br /> c.- � <br /> $�D 7 G./. �y .'ti n Q .) <br /> PROJECT ADDRE38 <br /> Owner Mail Address City Stele2lp Phone <br /> /-� � <br /> T2�an1 Mell Address Cily Slete2lp Phone <br /> . <br /> �s ,«< r 5 /i 3 P,� � iF: �P� 4�,� 9s� y�Si <br /> EI�_trical Con�redor Mell Atldress City Stele/Zlp Phone <br /> � �� LC� �. 5 Z U 1 2 ) L^. �.5� � <br /> State License Number Contract Price of Work <br /> .�_ ..n'r 2 s'7 6ffL•st � o <br /> Proposed Use o1 Bwiding Contact Person (Plen Review) <br /> Descnption ol WoAc to 3e Done. _/��/''�s�D � l <J' � i � �o��t � S y-� <br /> �fh <br /> NOTE: WIR'NG IN NON•DWELLINGS IS REOUIRED TO FEE <br /> BE 'N RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TA7(CODE IS J106 <br /> I heroby cerGly(hnf I h+ivo iend end nwnmirred flris applrcntion nnAkriow the�ame to 6e fruo and �u''Z.- I -� �� <br /> currocf All provisions o/laws and ortiinences t�ovornrny fhis fypo o/work nall be cornplefeA <br /> n�hefher specdiod herern or not Tho g�nntmg ol e pormrt does rmt rasumo fo give eufhonty fo <br /> vroln(o nr cancel flrA provis�orrs ol eny oflrer slafo or locol Inw reguP(ing rnnsbuchon or fho <br /> peifomrAnce u/r.orrsfrucfion. Thaf I nm aulhorizeAhy fho owrrei ol fhis proparty fo perlonn Iho � <br /> �vork lor whiclr epplicntion�s nr.3Ae enA I conrply ivrfh Ilre Sfale Conlrac(ors Lew iB 77 RCW and <br /> 29G 200 WAC. <br /> I _ _._-._—------� <br /> / 1 � y / J <br /> 's�� , uc oa�� <br /> I --- --- --- <br />