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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SER\/ICES � , _ a o -� 7 <br /> 3200 CEDAR STREET, EVERElT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 - www.evereltwa.org L O 7// -�1a,3 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> _ , \ <br /> � ,— ' . �� � `- I. � � � � � . �:'�� �' � - <'�� V L� �. � �� �� � <br /> � ' <br /> PROJECTAD^RESS <br /> '�..' � ' i <br /> ' --,l \� ' � � -- <br /> Owncr � 1.1ai1 Address Cily Stale/Zip Phone <br /> �` il��,C: lr�, � "�i ��,�� <br /> l <br /> TenaN Mail Addmss City State/Zip Phone <br /> Yf «��- <br /> ��>,� .��;� ;����< <o�-��,co� � r�,c�c<s I �ZI� ���1�\�EU`�.\�� ��2� �.c��`�c� 4o�z <br /> Elec�rical oniractor Afail Address City Slal ip Phone <br /> � _ I�-�,���,:;"-.� �-�- �1C11 G�., � �� �.��'o�� u� <br /> State License Numbrr Cont �ra_t Price ol Work <br /> i <br /> � � , � � ` `� �� �'�`� - <br /> Proposed Use of Ouilding Contact Person (Plan Review) <br /> Description of Work to Be Dono: 1- •'-k-- V G\� 1�'�`�� �� �'�C��G `� \C`� Cj <br /> fJOTE WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> �E IN RACFWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 herebt�certily fhuf 1 havo reaAnnd examinod fhrs applicafion anJ Hnow the sarne fo be f�ua and <br /> conrr,f All pin��sn�ns ol Liwc anA oid�nnnr,es povernrng Ihis typo ol�vork wdl be cornplefeA <br /> whefher speciGe,d hr.roin or nof. The�ranhng ol a pernuf Aoes nof presurne to give authorify to <br /> viol.�fa or cnncel Ihe`vovisions ol any other st�te or local law regulatin�consfruc6on or the <br /> peAormanco o!oonstruchon. Thaf I arn authorized Gy the ownor o/thls pioperty to porlomi tho <br /> work lor which npplication is rnadr, and I comply wifh the Stofe Conbacfors Lnw iH.27 RCW nnd <br /> 2�J&200 WAC. I <br /> / <br /> � ' — � ��� <br /> _ � � �� ' _ � �� � � _ <br /> Signaturc �alc , �� <br /> t G7 il iL3 <br />