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� <br /> .� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT 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 - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> /D S /S` �d• r...r[ .✓ (,��)v <br /> PROJECT ADDRESS <br /> ��iin� I' �,� e,. hoL�z �t� 7.S"�/-s��$ <br /> Owne� Mail Address City State/Zip Phone <br /> � �AnitS /�S/S' Cvcry/ec.�_L...�-. �vL.e� (� �/ 820$ <br /> Tenant� Mai�Address � �City Stale2ip Phone <br /> g�rr✓ N�o,� t� 7�/0 0 //�..-/.�ov /zA �ve..�� 4.E- `7$za 3 y�S-7�L-883� <br /> EleCtric Contractor Mail Address City State/Zip Phone <br /> gG//.i.v [o SC S-L 3 � �O o. o 0 <br /> State License umber Conlract Price of Work <br /> cAi I :.� S-�t,�� �to..t L <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description af Work to Be Done: %�v5�4 Lt ��� L '/- � ' <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> � <br /> t <br /> CITY OF EVERETT LOCAL SALES TAX CO�E IS 3105 <br /> 1 hereby certify that 1 have read and exami.�ed this application and know the same to be true and <br /> correct. All provisions of laws and ordinances governing this type�f work will be completed <br /> whether speci(ied herein or nof. The granting o/a permit does not presume to give authority to <br /> vio/ate or cancel tne provisions of eny other state or/ocal/aw regulating construcfion or the <br /> perfoimance of construction. That 1 am authorized by the owner o(this property to perform the <br /> work(or which applicatien is made and 1 comply with the Sta:e Contracfors Law 18.27 RCW and <br /> 296.200 iNAC. <br /> � '�f Z -' /6-�•S� _ /��J/�� <br /> S' at Date ,5.,W <br /> "J <br /> Eoso2-o90 <br />