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S cK <br /> � 3� @ <br /> �' � � ��. �� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SEkVICES -� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 ' '� <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org p',� � <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 1\�I`t, <br /> --ttt`f' �ve�e<<r�E,.� �v a.� � � �U� cJfl g 8 Zo� <br /> PROJECT ADDRESS � �� I �� O �U o NC � P �� �6�p0 S � <br /> c�-Z 5 <br /> �L� ���.��:1� . P.o .�X � �t��g �M`,ae�c�K{ W� 9808z �� g��„z <br /> Owner Mail Address City SWte/Zip Phone <br /> ,t�-- c� Cl t� '� � . Il <br /> SL'iI �6 S�JQ.��5 <br /> Tenanl Mail Addnss Cily State2lp Phone <br /> 1� I�/iNt Qo�,r E�cxv�l �vcS 11I\1 `o�.l`��`' Pt- �/l-: Lk.SI-e�re.r�3 ��-� �t� <br /> EleCtrical ConlraclOr Mail Address Cily Slate/Zip Phone <br /> D � V �►.s `�E Q`�-���= ZS�G" <br /> State License Number Conlract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: ��� ��«�-C� S� "�^'��— ��^- <br /> � �P�C�56� Cct�nrs� / ?-v U <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 /> I hereby certily that f have read and examined this application and know the same fo be true and <br /> correct. All provisions o//aws and ordinances goveming tliis type ol work will be completed <br /> whether specified herein or nof. The granting of a perm�t does not presume to give authority to <br /> violate or cancel the provisions ol any other state or loca/law regulafing construction or the <br /> pe�formance ol constructron. That 1 am authoiized by the owner of this property to peAorm the <br /> wor or which applicafion is made and I ompiy with the State Contractors Law 18.27 RCW and <br /> 2��0 WAC. <br /> `��t�� �� � 5 d� "� . �C� <br /> Signalure Date ,y )7 <br /> �ql/"� <br />