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4 � a �-�� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 982G1 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ��'��� �U�h� �f'. 7iidf /- Lb� <br /> PROJECT ADDRESS� <br /> ��.(�l,l�l�,$� <br /> ��-� � -�►i (�c-�I -�ti� ��v� ro��� AL��y� i� ������i� ���o� <br /> Owner MailAddmss iry Stete2ip Phone <br /> �u�.�%n ��nC�P �l)illl ��i�i/Grcc�� �E'n�� <br /> Tenan� Mail Address City Slate2ip Phonc <br /> yZ5 7yZ-c8� <br /> �1Y�u'fi� �lPclTi� -���5 i�)��� Si. S i�J.�'fl 1-u��ar�t�� , cc�H � c'��'1 <br /> Elettri I COnlfactof Mail Address Ciry � Stale2ip � Phone <br /> , � n <br /> �'1�1f1�'��D�� � li, �;��! — <br /> State License Number Contract Price of Work <br /> �'�ul�i Ac�vv�a���� <br /> Proposed Use of Building _ Contad Person (Plan Review) <br /> Description ot Work to Be Done: ��.��P� ('���'c'�� i �t�`��l���� �'F'���fG�' �/�;���:�''� <br /> � �/ Vi <br />� �'� ' � ��,�-c �-„f:���i 2�� 1 ��r.�/'1 � <br /> , <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO fEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> !hereby cenily thaf I h,avo read and examined fhis application and know the same fo be We and <br /> correct. All provisions o/laws and otdinancos govemmg fhis fype oI work will bo compleled <br /> whefher spec'ied Iterein or not Tfre granhng of a permd does nof Pmsume fo give aufhonty to <br /> viola(oorcancelfhe provisionso(anyofherstafoorlocallawregula6ngconsWc(ionortho <br /> peAonnance of construction. That I am acfhonzed by Iho owner o�:his pmperty lo peAorm fhe � <br /> �vork Ior�vhich applicalion is rnado and 1 conrply�vith fho Sfalo Contracfois La�v 18.27 RCW and <br /> 296.200 WAC. <br /> � ���1��� ,�-l�'tDn ' �-f-I q-(�lo <br /> �� SignaWre Datc <br /> l.�'U� ��C,7� � <br />