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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES S-�d-�� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 C 120S-d� <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM a AM TO 4 PM <br /> A" O % J � �O i � Y ,/c�G✓Q'V/ <br /> PROJECT ADDRESS <br /> �,�'Oc I r �`—/�—' "�TO'j�'f ��' -- <br /> OWner Mail Address Cily State/Zip Phone <br /> Tenant Mail Address City Stale/Zip PFwne <br /> /��o rf� �'n .� r�7 ,(��r�r� � `.b � <br /> Eledrical Conlractor Mail Address City State2lp Phone <br /> c� 'Fj 215� <br /> State License Number Contre t rice of Work <br /> Proposed Use of Building Contact Person (Plan Revlew) <br /> Descriplion of W�rk to Bo Done: ��,i r� � v D s y /�� /ve w , 7 o/�1Y <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE �O �� <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby cerlily thaf I have read and examined this applicafion anA know the same to be We and � I 'ZO�—US� <br /> correct. All provislons ollaws and ordinances goveming fhis type o/work will be completed <br /> whefher sper,(fied herein or noL The grenting o/a pemtd does not�resume to giva authonty to <br /> violate or cancel the provlsions o/any other state or local law regulating constructfon or fhe <br /> peAormance o/construction. That 1 am authorized by the owner of this Properfy to per/orm the <br /> .—worir/or-whichepplicalion is made arM f can/�ly with the SfateGontroctwslew-f8.-2�-RGW-end <br /> 296.200 WAC. <br /> �' �O� �� 5���a IiZ <br /> ignature D e <br />