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/ <br /> ELEC;TRICAL PERMIT APPLICATlO�f <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 3 AM TO 4 PM <br /> ; � <br /> /�� ,l7 — /i� �s-� l = ��,� /-��i� <br /> PROJECT ADDRESS <br /> yLs"-3s�s-6�� <br /> , ;f , , � < < -� , '' 3. � .•, /sG- i'1,�� 9�zsz <br /> �'i',� ,- �= /c_ , ,,�„ ;,.,:. i iL� Gr c . � c ,f- ,� <br /> Ovmer MailAUdress City State2i Phone <br /> '"� f� /1 ii�F �CSf fJ/ <br /> �f � - /7 z —/« :;l .T,6/IlZ�;� ;= �;.��,- <br /> Tenant MailAddress Clty State(Zip Phone <br /> 3�����%3�/S/� <br /> ��i � �/ �,F�i� 70/S Z7c���Sfi(/� ��,c�/��/)/� %�Z1 3 _ <br /> EleClricalContraCtor MeilAdOress City StalelLp Phone I <br /> I <br /> /r'i r�� �=i- � y�� n �- ��3��c�, ��� � -r�� <br /> State License Number Conlracl Price of Work <br /> � �l- <br /> /�"r-, ^;',..: / _ �. .� .-„ ��,Lo-_. i•��..—�--. , <br /> Proposed Use of Builaing Contaq Perscn (Plan Review) <br /> Description of Wod:to Be Done: /� �' i�' i �1�"�" %' � ��" `�'�'r � 1 /�%P'� -N ^� <br /> i i <br /> �� �/F ' � �� S�`✓.c � /��- -r' ��� l ! -�i� - / � � ,l�i;� <br /> / � <br /> � <br /> `( � � ii�ffr�t n/1i 'f1J - � J ( ^� '=� < �a� .�-� � rl, ./, �� <br /> —7 � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE ��=o c <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> i � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �L,�� G�Z �. <br /> 1 hereby certily that I liave read and ezamined fhis applicafion and know the same ro be true and <br /> conecf. All provi:ions of laws and ordinances goveminq this type of work vnll 6e comp�eted <br /> whether speafied herNin or noL The granting of e permd does nof presume to groe aufhonty to <br /> violafe or cancel the provisions of any otherslale or local law�gulsfinsg peronstruclion or(he <br /> ' wo�rk f r whichf pa pli5eatrotn s madet end 1 compty with the 3t te Cont2�ctors Law 18.�7�RCW and <br /> � 296.200 WAC. <br /> I �>_. , " �� ,�- f ' _. _ ,�- _ <br /> i - <br /> 3ignaWre �� Date� <br /> I <br />