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i"t�' <br /> t' 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.or�D�C�,`���'/) I / <br /> , lJ ���D <br /> APPLICATIONS ARE ACCEPTED FROIVI 8 AM TO 4 PM JU� � � <br /> 3 ?O10 <br /> , ��B! rc w°�Ks <br /> , ,,�:� � ��� �� r�;,>�r �,��� � > >,,., %,�,ti r ,��. <br /> PROJECTADDRESS T 7"� � ��D <br /> G 10o�-I�°� <br /> ° � �, '����, � ?;f/ �i���l, -��1 �5cr� P-f�r�r��ld�l��� �E����,� , w �1 `���'��� <br /> Owner Mail Address City State/Zip Phone <br /> '�irv-I� -����-h %ll /�� � 'iF��f��crrl/ /Y� ll /Al�;y ��_rrf�fl� i,z�� �/f�Ji-�' <br /> Tenan� Mail Address Cily StalelZip Phone <br /> � � , <br /> ( l"�� •�� �r=r�-f� I�i�1r1%�l- y ') i�-i ,��r� .��)'� '�r��h A�h 7-���i��-���1��A 9F���%'�`i �%r r-��; ?��� <br /> Electrical Contractor Mail Addres's Ciry Sta�elZip Phone <br /> f�� . 7 <br /> ��i� �!�T-, �ic � I i� -�;��� �;� ,�� ��'�� ��3���, �c��� ,no <br /> �, .�� <br /> State License Number ,- Contract Price of Work <br /> i <br /> I(1;:�/-1���1 -���� �r ��,'. '.:ll ��,. � 7 �:,'I h �)��)I �'Cv_`J��`'�}'�l <br /> Proposed Use oF Building Contact Person (Plan Review) <br /> Oescription of Work to Be Done: J�f� : I �� ' �� � a`� ,^ � ��r� /�-': � i �/����F"� "�U �� �!+'l• �)i-�-;�_'> <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL.�,ALES TAX CODE IS 3105 <br /> I hereby ceriily fhat 1 have read and eA.amined this application 2nd know the same to be true and '' �'r�"� � <br /> correcL All provisions o�laws and ordmances goveming this type ol wak will bo complefed � `�l/ �� — � � <br /> whether speciled hemin or not The granting o/a permit does nof presume fo give authonty fo <br /> violate or cancel the prowsions ol any ofher state or/ocal law regWating construchon or the <br /> perlomiance ol construr,fion. That I am authorized.by the owner o(this property fo perform the <br /> worlc lor which applicahon is made and I comply wrlh fhe Sta[e Contrac(ors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �, <br /> " �� '� � �Z���U <br /> Si9na� e Dat <br />