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ELECTRI�AL PERMIT APPLICATION <br /> C!TY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8f357-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �/- �-�� <br /> - �//// <br /> .C,��� � ��� � �.i,�(. `�_� — `•-IIL.rtTLii C-- (i�`� � �7?.L L1'C� �7� .� <br /> /_ � �. .� : �—��.-�S <br /> PROJECT ADDRESS <br /> > , � � , �; :'���, � ��r. k'-� L:-:�CtT lt..�?� <br /> ����r=,t r�,, , _ �— — — <br /> Owner Mail Address City State/Zip Phone <br /> Tenanl Mail Address City Slate/Zip Phono <br /> ' t � � ''�LC. v� � <br /> •�c� i SN� .C ,�1' �L 4<� � JI.V (i 'V1.�"r '�� �I <s �-1 li �'lS�l <br /> EleclrlcalContraclor MailAdd�ess Clly StatelZip Phone <br /> 1 i.�i �>l� UCK_� I <br /> -T{- � C C 1 =>, �-1 <br /> State Llconse Number ontrecl Price oi Work <br /> Proposed Uso of Buildiny Conlacl Person (Plan Ravlow) <br /> Descriplion ol Work lo �e Uonc: �J"=��,,__--i 1 ._,�..-< <"•' �.��.. � ��� � 4t � :'. I <br />� NOTE: WIRING IN NON-DWELLINGS IS REQUIRED 10 FEE <br /> �G IN RACEWAYS, IdC OR AC CABL[. <br />� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 9105 . �- <br /> GL;�- <br /> I haehy��..afily Ifrnf I havo roa�d nnd exr+rninod this npplicnfinn end kno�v fhe sem�fo bo fnio enA _- `I`� — � , <br /> ronect. All provisions o�laws nnd ordinevnces qnv�rning fhis type ol work will6o complefeA <br /> �tliethcr speulied hc�ein or naL The yranling ol n pernuf does nof presumo lo c�ive oulhority(a <br /> riolale or cancel the/vovisions ol nny ofhei sfnte or local Inw regulnfing construcfion or fho <br /> pe�fomrance o!constiucfion. That I em nufhoiized Gy fhe ownor ol this property to pedorm the <br /> �vork Por which npplicafioni�ntnde anJ I cornpty wifh fhe Stnfe Confrncfors Lais 18.27 RCW anA <br /> 29&200 WAG / <br /> � . ��.�--�/ �J�— �— � � — - <br /> - Signahu„ ------ Date <br />