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( <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES 5 _a3-�� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org c_�—_ 1/O S-�Z� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � �� <br /> � L � �-�,; �i .��� ; � � � ,��� _ <br /> PROJECT ADDRESS <br /> � '�": t- � _ - - <br /> � � �.��''- -t �\\e-� �r1�r�\v✓1\-Sa�u `^ � ^�,.:��....1 n��i, '� � ��.� \\.�v- C.tiY��f.il lJ��`,C� <br /> Owne� Mail Address � City StatelLlp Phono <br /> Tenant Mail Address Cily Stale/Zip Phone <br /> � � � �,( � <br /> ���� � �"��, -��� '1�_�l� a i'�F � � � �l .�A�. ��,--�. '-'`� � ��`-1 i - �-��J � 1� <br /> Electrical Conlraclor � Mail Address City Stale2ip Phone <br /> i � <br /> \���. ����, l ._�'�_L�.�� �; �� i,�, : > <br /> State Lfconse Number • Contrect Price of Work <br /> Proposed Use of Builtling Contacl Person (Plan Review) <br /> , � � . � ..r. <br /> Doscdplion of Work l0 6o Dono: A�—'�� �������-� l� �� �� � ��(�� �-��� - ' ' 4� <br /> �J <br /> �� ,- . (� �. . __`1,_.l_A/ _ � ,�l / ( <br /> ������ � 1_ 1 l_� 'l�l L.���`��� 1� <br /> \ <br /> , , <br /> , , i� . ( � ( ' �,-A-.A �� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CADLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily fhaf 1 have reod nnd examined Ihis applicafion and know fho same to be(rue end <br /> correct. All provisions ol faws and ordinances govommg fhis typo o(work will be compfoted <br /> whefher speci�ed herein or noL Tho c�ranfing ol a pemut does not presume to give authonty fo <br /> violafe or cancel fhe provisions olany olherstafo orlocalla�v regulating constn�cfion or fhe <br /> perfomiance o/consfruction. 77iof!am aufhonzed by tho owner of this property to peAomi the <br /> work for�vhich applica(ion is made and 1 comply wifh fhe Stafe Confractors La�v 18.27 RCW and / <br /> 296.20�wA�. / ��y <br /> IG7� � <br /> , `' '��l , ;-_, � I <br /> �._ �. ��, �- r��_ ��� _ � � , <br /> SignaWre — Dale , <br />