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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 –wnvw.everettwa.org <br /> y ` � `-�� <br /> APPUCATIONS ARE ACCEPTED FROM 8 AM TO 4 PM (—y O�O (�� I�I <br /> � OIZ ��,E � �-i � )'� � l-u�rr� �t��' ZC � <br /> PROJECT ADDRESS <br /> L;r �.t�; Frn,,-�- - `1� 5- _ 25 � - 2 �-(C' J <br /> �Utl'r.Yrvo-� �[�y�nr� I�.i � ��C'� JUf'V�{^�r�� 1��- t �—CYVe�- �L 1�� �� C � <br /> Owne� ' Mail Address Cily �� S[ate2ip Phone <br /> Tenanl Mall Address City Slate�Zip Phone <br /> Su�ac N—yl �t:ti�-7��-4�'��� <br /> �7��i�fC�iVtr L�fc�C �C.�IAC . � �4(�;��� �llv6tq ��Jc �.� �l�atn��he �(.jfi ��� � � ��� <br /> Eleclrical Conlracior Mail Address City State2ip Phone <br /> 'iN(' t,r E-�R�;?N1 L �,�� �)(1(� ��� <br /> Slate License Number Con�c Price o1 VJork <br /> � <br /> i�r 1� , ��� . �' �� '-, ��y--•.� r��—��. ��,d� <br /> Proposed Use �uilding CoN.acl Pcrson (Plan efi.view) <br /> Descriptlonv(WorktoBaDone: 1_ C �' ;� �., � � ?r < S�ce � "�„�okr� L>��e���5� li��n-��e���i_��_ <br /> i <br /> r�, <br /> '- < \" � r-7 �]�� C��,,, (��� rt � � <br /> _ ( `J <br /> . <br /> NOTE' WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> B[ IN RACEWAYS, MC OR AC CAF3LE. <br /> CITY OF EVERETT LOCAL SAIES TAX CODE IS 3105 ,rI <br /> 1 here6y certi7y fhat lliave read and examined fhis applicafion and know the same fo he true and tJJ�v� � I �1 <br /> correcL All provisrons ollaws and ordinances govermng this f��pe o!�vork u�dl be completed <br /> whefher cpecdied herein or noL The g�anlirtg ol a pemuf does nol presume to give authonty!o <br /> violafe or cancel fhe provisions ol any ofher sfafe or local la�v re�ulating consWcfion or fhe <br /> perlormanc e el construction. Thef 1 am aufhorized b}-fhe owncr ol thrs propeRy to perlorm(he <br /> work lor�ti�hich apPlication is made and 1 comply with the Stafe Contrac(ors Law 7827 RCW and <br /> 296.200 WAC. <br /> � ,/!�- , ,-� �- � �� ., � �.- <br /> _��a�(��.,. �yY�� 5��;�' - �L �r . <br /> ignaturo —� � ' Dat�, <br /> � � <br />