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�; _ <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, E':�RETT, WA 98201 <br /> 425-257-8810 - FAX 425-257�8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 36 �q Colloy Ar.e <br /> PROJECTADDRESS • <br /> �y'z 5�311-�Ior3 <br /> C S .� fJc� s :o�i 3�1�1 -col�, v ��P f,�e��� r �3 9 20� <br /> Owner ailAdUress Ciry Slate2ip Pho�e <br /> --Six.v��f <br /> Tenant MailAtldress City StateRip Phone <br /> �'�G,+�� �/e� fr� Tc�c An (3nx ?95"t� �ve��ul� `�SLl3 �yi�� yz�z-�}o <br /> Electri I ConUactor Mail Address Ciry State�Z�p Phone <br /> _ ��l (r1� � S �I77 �- �- z,53 `� �`' <br /> Stafe License Number Cont�act Pnce of Work <br /> �d�u lu`'!,f t ��ct, I <br /> Proposed Use af Building Contact Person �Plan Review) <br /> Description of Work to Be Done: _ 1 S.i0 G /�c�U f 5 � X'�-Y GZ���i0 5 �'r^V c �F l a ��d/�r y�� <br /> 1 � v � <br /> /��4L� Q�Q A �2) �Wp�11L G �C(,�,t�t'} LJ ��,� �2���Q���( <br /> �1 L� C. I P C • <br /> NOTE: WIRING IN NON-DWELI.INGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. /. � C� � <br /> `r� � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I here6y certily tliat 1 have read and examined Ihis application and know(he same fo be tnie and <br /> correcL All pro��isions ollmvs and ordinances�oveming fbrs type ol woik will6e complefed <br /> whefher specilied he�ein or not The granfing o/a pemu!does notp resume to give authori(y fo <br /> violafe or cancel fhe p�ovisions o/any other sta(e orloca!law regulafing construction or(he <br /> perfomiance o/construchon. Tha�I am authonzed by the oit�ner o!fhis propeRy fo peAomi flie <br /> worir lor which application is made and I comply wilf�fhe Sfale Con(ractors Law 1827 RCW and <br /> 296.200 WAC. � <br /> / <br /> , �Q�� ��> > <br /> � ignature —� Date �� <br /> t� � � <br /> , <br />