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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 —www.everettwa.org I�` �'�V�'S <br /> APPLICATIONo ARE ACCEPTED FROM 8 AM TO 4 PM �OS I�`I�I� <br /> :�c?;'`� �'Y�c. aC9,� :ac F= /_-,_.�..�._�7 _v/�. `'�,� �l <br /> — , <br /> �ROJECT ADDRESS <br /> y3�- <br /> (�i;N,'� CXCo7T zziy ciP�..�,d�:D .4��. i��rr7 c�/� 9Fsd�i �3i-v-•� -�: <br /> Owner MailAddress City State2ip Phone <br /> �ifaf��' � ��'JC.-L-� , \ � _.� <br /> Tenant Mail Address City State2ip Phone <br /> J/J,Y N h�'L�:��i (1 •--�-�. •��.. . <br /> cZt�N-�t <br /> Electncal Conlraclor Mail Address Ciry Stale2ip Phone <br /> State License Number Contract Price of Work <br /> Q�-ti�� /J0�27� <br /> Proposed Use of Building Conlacl Person (Plan Review) <br /> Descriplion of Wark to Ba Done: �z�/�%`��E' �«��Q d-7�8� w�Ra ,,� C�/'c�.,7S ¢1/j f iS <br /> ( i3c�D�'o�rra /c,rcd�Hd-B�fl�(I C,�G7S� Gc,.+� �cr�r�� PJSS.B/C� Lj�JG/I4dPS' <br /> � J— l <br /> ( iP /11ST.1/l rF� OGTCc? .in /S'47 ri �.' r Z � Sy�d/ � /.A�1c <br /> N��y .L � a.>,�- J,s•x;•ai - I' -e <br /> e/Lc�,r ,y k,Tci,fe,.� <br /> NOTE: WIRING IN NON•DWELLINGS IS REDUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily thaf 1 have read and examined fhis opplicafion and know the san�e fo 6e true and � <br /> conect All provisions ol laws and ordinances govemmg this fype ol work will be complefed <br /> �rhefher speahed herein or noL The c�ranting ol a pe�md does nof presume to�ive authonfy fo <br /> violafe or cancel the provisions of any otherstate orlocal law regu/atrng construcfion orlhe <br /> peAorriance o/conslruclion. Tlial 1 am authonzed by the owner ol this properfy to peAorm the <br /> �vork(or which application is made and I comply wilh fhe Sfafe Confracfors La�v 18.27 RCW and <br /> 796200 WAC. :- <br /> -- , /�. <br /> / .. '�� __ / '�. _ .��� ��� � /�/��///`1J <br /> � lJ <br /> �Signalure " -- �– Uat� . <br /> �i%/ �!/, <br />