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ELECTRICAL PERMIT �1PPLICATION <br /> CITY OF EVERETT PERMIT SERVICES � <br /> 320C CEDAR STREET, EVERETT, WA 98201 /�`�J � <br /> 425-257-8810 - FAX 425-257-fi857 —www.everellwa.org C 07 � � � ��/ <br /> Cl <br /> APPLICATIt�NS ARE ACCEPTED FROM S AM TO 4 PM <br /> � �/5��n��%� �/�� - <br /> PROJECT ADDRESS <br /> JWner M17ai1 Address City Slale2ip Phone <br /> •�/' ,� // <br /> J�/��� ���/�/I�t��i <br /> Tenanl � il Address Cily State2ip Phone <br /> J � � �/ t�'°l"- ,���5� ,�/ .<� � /,✓� �c�� ` <br /> �� �/�,y�' I'/c� �,-. ��� J- I✓ .�/rt�i�ivs �,t � �' <br /> Electrical,Gonlracbr Mail Address City State/Zip Phone <br /> �'/u-�%�/.;Zi/ <br /> �/,Gli'�'/.l,t',-(�rrl��/� ''��J�7 — _ <br /> Stale License Number Contract Pnco o(Work <br /> / � <br /> /.� -�"�� �/l �i � �.:�i. // �!i/ /�' %�'`-'/? <br /> P or posed Use of Buil� g Contact Person (Plan Review) <br /> �— / /� > � <br /> Descriplion of Work to Be Done: ,�N�r'�i// ���i'���"�`� [J ' � /(��'J / / f/���� <�1��;� <br /> i i <br /> ✓' <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEVJAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily fhaf 1 have read and examined this ap�licalion and kno�v the same to 6e We and <br /> r,orrect. All provisons of laws and ornirances governmg ihis lype ol�r�ork n•i116e completed <br /> wheUier specibed he��in or noL The g�anfing ol u permit does nol presume to�ive authonty to <br /> violafe or cancel the provisions o(any olher sfote or local law regulating construc6on or the \ <br /> pmfomi�nce of construction. Thaf 1 am aufhonzed by the owner o(this property fo peAom�fhe ��� <br /> work lcr w9iich�pplication is made and 1 comply with the Sfate Controcfors Law 18.27 RCW and ` � � <br /> 296.200 WAC. �\\ <br /> �-!',�- �„i,� !/%✓�/% <br /> i " � IgnaWre-� Date <br />