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. <br /> f <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVEftETT, WA 98201 <br /> 425-257-8610 - FAY,425-257-8857 —www.everettwa.org � -/6 -0 7 <br /> APPLICATIONS RRE ACCEPTED FROM 8 AM TO 4 PM ��7D /_D�/ <br /> o?SO,;L (�p�.p� <br /> PROJECT ADDRESS � <br /> Owner Mall Addmss Cit <br /> Y Stale2ip Phone '! <br /> ?'4L^- Es(c:1—S_ 4` <br /> ���z�cs -Jc�S � ��I� h�;n;k ii�s:Q�) -S�,�vl��:r�sla l��l� `��.��1� <br /> Tonant MailAddress Clly Slale� •'," f�5.2 �r+p�� <br /> �/Lr�}-it;t7C �L�Gif�>C: �o �'z^X �1t5 �1,{a2..� l�J`f' �1�i��=' <br /> EleC�rical Conlrac�or Maii Addross City SlaleRip Phone <br /> ��/LC i1 !�`l�1i�'� /7 z� c�� <br /> T�. J�1 <br /> Stale License Number Contracl Price of Work <br /> �i��A%t .�i�/��C� <br /> Proposed Use ef Building Contacl Person (Plan Review) <br /> Doscriplion of Work lo Do Dono: �,_ . <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> B[ IN RACEWAYS, MC OR AC CABLE. <br /> >,��� . �� <br /> CITY OF EVERETT LOCAL SALES 7/�(CODE IS 3105 <br /> I hereUy certi/y fhnf 1 have read and examined fhrs applica(ion and know the sarne to bo true t�nd <br /> co�recf. All provisions o/la�vs and ordinmicos govoming tlas lype ol work�ri/l be com�lofed <br /> wheN�er speaficd he��in or noL 77io flranfing of e pemuf does nof presumo fo gi��e aufhonty to <br /> violate or cancel fhe provisions o/any other stafe or local law�agulating wnstniction or fhe <br /> wurk lor�vBich appl cafiori�'s n�'du and�l conip%y�tiitl fh'o Slafo Contrac(orsuLa�v 18.27 RC1W/and <br /> 296.200 INAC. <br /> [�—LC�'i���- �//lo%�'" �/�I <br /> Signature ��a ' � x <br /> ^� �� <br /> � <br />