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� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVi��S <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettvda.org <br /> � APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � — ')-0 .p� <br /> `ii, I � � �i?'c,-("1 1'� !�-v' -�2 c T'1 <br /> PROJ[CT ADDRESS <br /> rp IZ�LLL <br /> ;��'l{t�r� i-l;LLc►.; �07 (L-� '-� l�L N�' �i;-r�-1 Vv;�i �r"�c;z <<<'` �Z'i��Ef � <br /> Owner Mail Address City State2ip Phone <br /> Tenanl Mail Address Cily State/Zip Phone <br /> -.k���.r'> �t��?P�C, 1�.1,� `t�Dii �7L-L^I i�ZL�NIs''iJi.i 1�/,/� �ti;%2> �3�� �r'3'�'`l�� �3 ( <br /> f_lecirical Co�trac�or Mail Address Ciry State2ip Phone <br /> ,, ^r , > <br /> ��; <br /> �'��i%�)`' r.•L_�-, �� _ _ _ <br /> St�le License Number Contract Price of Work <br /> �c_i_�111i 1�J ; I ,ll� <br /> Proposed Use of Building Conlacl Person (Plan Review) <br /> � � � � <br /> Descriplion of Work to Be Done: �. i��, - �-�:�. � ,'��--1:, ')� i Lv� �i1�.1 �1,�, i . <br /> /�t�/,` , I ti`�j��l �:I, �_�_V t.l 4'_l� �3,/r'-if. ��(i�h{��l] �'�-L�'' I <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> �E IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I I iiereby certily fhat 1 hava read and examined this application and kno�r the same to he Irue arid <br /> I r,orrect. All provisions ollaws and erdinances�ovenvng this type ol�vork will Ge comple(ed <br /> I ��,liether speci6ed herein ornoL The c�ranting ola pernut does not preswne fo give authwity to <br /> ��iolate or cancel fhe p�ovisions ol any ofher state or local lmv regulating construcGon or fhe <br /> I peAorniance ol construction. That I am authonzed by the owner o/this property fo perlomi Ihe <br /> �ro�k lor wbich application is made and 1 compty�vifh fhe Sfate Contractors La�r 18.27�4CW and <br /> , �96.200 WAC. <br /> i� �� <br /> ( !�� f�. :l''— 2� fz'' �UU� <br /> � <br /> � Signatute Date <br /> � G iU7 1���- <br />