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� <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.evereltwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �l«� �� �t�3;�,� s, �� o <br /> PROJECT ADDRESS <br /> ya���1�-s�Cal <br /> �'k,�z c,�>�L�- J��,•N y '�-l- /(?i' '":� ;<�.�v�x� — �i��.�//�,� �,��i, <br /> Ownor �7ai1 Addrass Cify Stale2ip � Phone <br /> i <br /> ��T <br /> Tonanl A1ail Address City �� � - � � 'Stale/Zip Phone <br /> ,/-'� S� � � � �' I�G. �3<� /9 3� `7y'� �.� l/R 9�,������ <br /> /� •i�„ �.Y��. � ;..�� , /tc� � � � �,i.� <br /> EloClriCal Conlraclor Mail Add}oss I �1 ' Slate/2ip Phone <br /> �-�,9� 1/�� �9��� r ( �,� � � �� � ��� <br /> Stale Licenso Number � Contracl Prico of Work <br /> 5`^ <br /> Propasod Use of[iuildinc� Contacl Porson (Plan Raviow) <br /> v / l/ / <br /> Doscription of Work to Bo Dono: �� ' /i/-' ./_tA�/1�� L'!'/�[�7 .rfl�_�` A"�lt�v.�i' <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEVVAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 heroby certify thaf 1 haro road and oxarninod this appllcotion and kno�r fho same fo be Wo and <br /> corresL All pruvislons ollairs nnd ordinances�ovoming thls f}po ol�vork will bo complo(od <br /> uhother spoci�ad homin ornot. The�rmiting o(a pomut doos nof rosurnu to givo aufhonfy to <br /> violato or cancel tho provlsions oI ony other sfate orlocallaivroguPating conswetion or fhe <br /> porlom�ance of construction. That 1 arn aufhonzod by the owner o/thls property fo poAorrn the <br /> �vork lor whlch applkafion is made and 1 compty�vith fhe State Confractors La�v 18.27 RCW and <br /> 296.200 WAC. <br /> �� . . <br /> �.-�� ��;Gj.�.����'-���.� � ���� <br /> " Slg�a ra Dale ' �� <br /> �� � � �� <br />