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_ /D -�7 - a � <br /> E�ECTRICAL PERMIT APPLICATION <br /> CITY OF EV'ERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> .�,'`1c�'-�- C'�t.�� 5c�_rTC 17 Ev�zt-7� 982n� STK�-7 �-ve� <br /> PROJECT ADDRESS �EIJrI h!i �� <br /> '� k�rt�=�� �� Esil�'rG ,2%0� Cr:L;,y Su<-r� rzm Evez�z'r ��/� `7��j� <br /> OWner Mail Address Clly SUte/Zip Phone <br /> Tenant MailAddress City State/Zip Phone <br /> �-�.w.u�r� Ctc-cT �i�o v�x a9t� C�lf�2�7' W� �'1�21� -1zS �s1�� <br /> EleClrical Conlraclor Mall Address Clty Sla:e.2ip Phone <br /> C-=� « ,., � � � ��,� s�a" <br /> Stalo License Number Contract Pn-.c•of Work <br /> �� 4 <br /> r ' <br /> =10L0�.1 �+1t2 <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> Dosctiplion ol Work to Bo Oane: �EFJ ia NT �v�472o11r�ug,T - <br /> NOTE: WIRI�G IN NON-DWELLINGS IS REDUIRED TO FEE <br /> B[ IN RACEWAYS, MC OR AC CABLE. <br />� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> I hereby cerlify fhaf 1 have read and examined this application mid k^ow the same to be Wo end <br /> concct. All provisiais ollaws and ordinances govenung this type o/w�ork will be complefed <br /> �rhefher specified herein or not. 71io granfing ol a pennrt does not presume to give authonty fo <br /> violafe or cancel the previsions ol eny other sfate or lecal la�r rec�ulatinr�construc(ion or the <br /> perlormanca o!consfn�cliai. That 1 am authonzed by fhe owner o/thrs property to perfam fhe <br /> �vork lor which application is made and 1 cornp/y�tiith tha Sfale Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> 'l2��'t��c�-- �a`i� G'( / I � � <br /> Signalure Dato " �J� <br /> - �i; <br /> � �� <br />