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ELECTRICAL P�RMIT AwPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � .1�/ `�� <br /> 425-257-8F310 - FAX 425-257-8857 —www.everettwa.org // <br /> AFPL!CF."'IOf�iS ARE ACCEPTED FROM 8 AM TO 4 PM v��U S"�Yy <br /> / <br /> �� �� � ,� <br /> � ��' I � � �') �' i 1�'�U'. �'i'�,��t' � <br /> PROJECT ADDRESS <br /> n <br /> ( �;;,,,�,.,, ; �.�������!', `a').Y'�� � ,���' Tt'�I�1 � 1%J,�G��"��'1�'�: � <br /> I Owner �� MailAddress City Stale/Zip Phone <br /> � <br /> Tenant tdail AdCress Cily Slate2ip . Phonc <br /> (4�r"�: i�2-��; �r�>r:iz <br /> _}� � -'I�I�A )�.( �_� �� �"��11 ! � � -��V�i��.� ����/` �����— (� �°\Y", � !-5�",P �(�I'��v'i�i�'�����/��� ' <br /> Eleclrical CoNracto� Mail Address City State/Zip Phone <br /> 1 � .� j'�! l )1". _���� �i�t `�.�-7 �N 6��)i��'J <br /> Slale License Number Contracl Price u(Work <br /> �L���� <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> { r <br /> Descriplion of Work to Bo Done: �"1. i' 1 .��� �' I' 4�.�. ',�(,'t- '�.J( ���/� �i i,,i,,��.. 1 t�i-('�)�, \ , <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RAC[WAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> � <br /> I liereby certily Ilwf I have read and examined fhis applicalion and Hno�v fhe same fo be fiuo and �-- � ( ��'C� <br /> co�mct. All provisions o(laws and ordinances yoverning fhis type o(u-od<<ti�ill be completed �_ [. Yy <br /> �:hefher spea6ed hcrein or noL The r�ranfin�o(a perrnd Aoes nof �resmne fo give authonty fo <br /> ��iolafe ur cancel fhe provisions of any ofhar s(afe or local law regul�ting consVuction or the <br /> perPorr�iance ol construclion. Thaf I arn aidhoriz2d by the oisner o/this prope�ty to pe�form the <br /> u-ork for�vhich applicafion is mad�and I cornply u�ifh the S(afe Confractors Law 182i RCW and <br /> 29f.200 11�AC. <br /> � <br /> ,_. <br /> ;� � �- -; /�, <br /> Sl�nature � Qate <br /> � I <br />