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i <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> . , �� � � , �_ � � � � <br /> �S 5 � ��. � ��zs ��7%�-_>s� y <br /> PROJECT ADDRESS <br /> � <br /> I, <br /> p /� µ' L � �.� j�. <br /> �7��� r' �j� ,'1i:1�•�(1�4� � � I� ��lf���/ I�t �✓ � �1i7w(� ` �G� � <br /> Owner Mall Address Cily - Slate/Zip ( L1zS� ���Ph�?� y <br /> 1�, (/�� %�� <br /> �L�I� ; U '���� � -,�{7 �� 7<' i �/ ���-�� C Lr������� �bf,l�t�i t �„A- �/�✓.=.�C-; � <br /> Ten2nl ( ( M17aill ess Ciry Slate/Zip Phone <br /> �/ .J_{- .___— ...__ _ _ __--� -- -— <br /> / 1 <br /> Eleclrical ContraClor Mail Address Ciry State/Zip Phone <br /> ,�//�- �ti �+ <br /> Stale License Number Contract Pric�f Wo� <br /> ��� �� /� i <br /> Proposed Use o(P,uilding Conlacl Person (Plan Review) <br /> i I <br /> Description o(Work to Be Done: (/�F� o �.J C'c7 �PI :.d� °i r� (Oi1�1 �I`�i r'i' TU <br /> ��1����� <'1 IV� ,'� ��t"/�� i,� i -� (f ' �� � '� ��,r S� �� � �- ����7i �') � U �ti\1'� ' <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 � r)i��j•�,``��� 1-� <br /> 1 hereby ccAily thaf 1 have read and examined fhis ap��licalion and know fhe same fo be frue and <br /> � L J <br /> conecL All provisions o(Imvs and ordinances govenung Ihis type o!work wdl Ge completed <br /> �ahether speci6ed herein or noL The grantinc�ol a pernut does not resume fo give authonfy to <br /> violafe or cancel Ihe piowsions o/any other sfate or local law reguPting constn�ction or tho <br /> perlormance olconsfruclion. Thaf I am aufhorized by fhe o�vner of Ihis property fo perform the <br /> work lor�vhich applicatiowis made and�niplv with fhe Stale ('onhactors La�v 18.27 RCW and <br /> 29G.200 WAC., ' � <br /> �_..i ��/�'�'__ // . <br /> ,T <br /> `� �,.��� (7 <br /> � , i ���.,i�`j <br /> Signa�ure�. . ... Dalc <br />