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i <br /> i ;: , <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-d857—www.everettwa.org <br /> APPLI(,ATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> '1 `-I i �� G; ���.�.,,.; .��_ <br /> PROJECT ADDRESS <br /> �- <br /> -�,�>a_ �c�ti�:��� �-�y t,� �n�_��� v�. ����1 �.�a ��,>��� �as-���-�,��tt <br /> OwnBf A9ail Address Cily Slate/Zip Phone <br /> Tenanl Mail Address Ciry Slate/Zip Phone <br /> .�� , � � � -� �� �. , r� t� t,� �14= �►t�(r. �i ��'-��!'���a � <br /> �c._�'�,,.� C.�=� � r� � t � ��: 1 Il; w �� �. ,- <br /> C-Iec�ricalConUaclor A4ailAddress City SWtelZip Phone <br /> 1�.21SS�'iL � 5.3 �I � <br /> $tate License Number Conlract Price of Work <br /> /,\ .{ 1 <br /> .JL1�'- �-A� ��� i�_.-1�� � ���.=� r� �' (�4."`(•. �' <br /> Proposed Use o(Duilding CoMacl Person (Plan Review) <br /> DescriptionofWorktoBeDone: I�4 ,.. �� ' ' � � l •,1 � `,i ,,;' 1 l�� . i,`' }�'t� ,, �� ���\ (�(1(�.4 . <br /> /� �r 1 � <br /> -(. �-.\! _.(i.•. �- -`���1'. 1 \�r:�J �'w.��,1�`i.. r`�,�1 1� ��: \ 4�,_,;,���'� <br /> NOl'E: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hcreby certily thaf 1 have read and examined ffiis applicafion and know fhe same fo be fnie and <br /> correcf. All provisions o(laws ond ordinances governmg this type oI�vark will be completcd <br /> �rhether specilied herein or noL The c�ranfing o/a pernu(does nof resume b give aulhonty(o <br /> violale or cancel the provisions o/any ofher state or local l.iw reguPting con5trucUon or fhe <br /> pedonnance o(construction. That 1 arn aidhorized by fhe o�vner a/this property fo perform(he <br /> �vork(or�rhich applicafion is made and 1 compty u�ifh fhe State Confracfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> , `�l�l,� 11' <br /> -, , , <br /> •u' , _ �.___. J- �.�.�� � C� <br /> SignaWre Date <br />