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t� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-6857-www.everetriva.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> /J�-;� ��'�-lli;i� �; ;�, �� �/�' %�'�/ <br /> PROJECT ADDRESS <br /> %/' ) <br /> `✓/�/l�f .�I,��/�/I� � ��s �C /%� //�../y�uli��� 7"�!J'�--� "�j'� <br /> Owner Mall Address—�� <br /> Clty StaleZp Phone <br /> -_[11�i. <br /> Tenanl Mall nddress Clty State2lp Phone <br /> 7�l'Iz�_ <br /> Eleclrlcal Coniractor Mail Addrees CIN Stata2lp Phone <br /> Stata Llcense Number Coidracl Prlce of Work <br /> Proposed Use ol Building Contact Person (Plan Review) <br /> Description o1 Work lo Be Done: _ �fl/�'��� �i�/�/� �r /�� ���G)t,�� , � <br /> J <br /> i�l ///!� ,,��/ /r��.��r'i�!'lr�irl i/i, ii> > i_.ri'�'«d�� <br /> �i/.� i// �� • <br /> yil�• <br /> '� <br /> NOTE� WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> B6 IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TA7(CODE 13 3105 <br /> l hereby cortily thef I have read and exemined fhic eppliceflon and know fbe same lo ba frue end <br /> correct. A/l provisions ollaws end orAinences govemmg fhls type oI work will be complefed <br /> whefher specihed berein or noL The grenfing ol e permd does notp resume fo give eufhority to <br /> violate or cancel the provislons o/eny other sfafe or locel lew reguletingpconsfrucfion or the <br /> wo�k oi wh/ch appl/caho�n is made�end I comply with fhe Sfere Cont a�cfos Lew iB 27 RCW end <br /> 296.200 WAC. <br /> � �J <br /> � <br /> I � <br /> � � ,, ,. //.S�D�i� <br /> Signalure ete <br /> ✓ <br /> Fasc�_o13 <br />