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� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES q_��„�� <br /> 3200 CEDAR STREET, EVERETT,WA 98201 �`I� �q,a� <br /> 425-257-8810 - FAX 425-257-8857-www.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM e AM TO 4 PM <br /> Q? 7 �9 �-����;�-�- ✓�v�. <br /> PROJECT ADDRESS <br /> '�(J 17C�1;��Y Hd�IH�iF 2T�'�)� ��}{hs� S� c7hfi�tbN4/ I� w�. <br /> Uvnef Mail Addroas Gty 3fale?Jp Phab <br /> �/f�./TS ��r c�oo�l <br /> Te�' Mall Addresa Gry Sfale/Zlp Pharo <br /> /�/��/�IS �';w� ��oc1t H.�' 7'7s' TB2G <br /> ElecMcal Contractor Man Address Gry StatdZlp Phme <br /> �bc�h.r_1� , c5-� <br /> Stete License Number Contrect rlce ot Work <br /> �'�o�C/ V'!/ti!( <br /> Proposed Use of B Contad Person (Plan ReWew) <br /> Descriptlon of Work to Be Done: ,�,�1A �`� vrv�/< ,�,2 (7.� Am p Se, v v Pa�t� �U� ✓�Ih p <br /> ��>J f-�c �� �l r <1 n C1 �✓1I'W 'YI�.N!r;/ <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO � <br /> BE IN RACEWAYS,MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby cortily thal 1 have read and examined this applfcetlon end know fhe same to be hue and <br /> 'correct. All proNsions of laws and ordinances goveming thls type ol work will be complefed <br /> whefher speclRed herein or not. fie granNng o/a permit does nofp resume to glve authority fo <br /> vlolate or cancel the provislons ol any ofher state w locel law repu/aBng construdlon or the '�/J <br /> performance o(construcGon. That 1 am eufhaized 6y the owner ol thls pnperty to peNom�fhe � / <br /> work lor whkh appllcetion Is made and 1 comply wlth the Stafe Conhac(ors Law 18.27 RCW and l I O <br /> 296.200 WAC. �1 <br /> i <br /> 4 3 <br /> Igna re DaM <br />