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, <br /> ELECTRICAL PERMIT APPLICATlON <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 8 AM TO 4 PM <br /> �� ��z/ �7-l0�1 <br /> �/le �.� ,� . ,�.�� <br /> PROJECT ADDRESS <br /> �'��0��1��� 3?�is ���� ���"ys�� �y�3 <br /> Owner htail Address City Slate/Zip Phone <br /> ��Q-nt,C— tl.�+.� Cc �F�� <br /> Tenan� Mail Address C��ty Slate2ip Phone <br /> �a..�C��p' �.T..�:,�...�. .�'S��9' `�L���llr'� ,(�G'�u�l`�Zo I ��oa <br /> Electricat Conlraclor M1tail Address iry State�Zip Phone <br /> �!!ff/TL��� /�tG �� �/ f �• d0 <br /> Slate License Number Contracl Price of Work <br /> ..J-l'_iLO�-d-E' <br /> Proposed Use of Buildinc� Conlact Person (Plan Review) <br /> Descriplion ol Work lo Be Done: (�! 1 � ` �� � CL -�/�� <br /> � �,.��� � �'���� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FE�(/ <br /> BE IN RACEWAYS, MC OR AC CABLE. 5yr.��� � <br /> CITY OF EVERETT LOCAL SALES TAl(CODE IS 3105 <br /> %� Ol- Oh'� <br /> 1 hereby certily that I have read and examined this npqlicafion and know fhe same to be We and � <br /> correcL Ail provisions ol laws anr!ordinances governmg fhis fype ol work will be campleted <br /> �vhefher spcalied herein or noL The grantin�ol a permR does nof resume lo give aufhonry to <br /> violate or cancel the provisions ol any ofher stafe or local law rer�uPting consfruchon or fhe <br /> performance ol construchon. Thaf I am aufhorized bp fhe owner ol0us property to pedoim fhe <br /> �vork J�r wluqh �pplication is ade an I comply with fhe Sfate Con6ac(o�s Law 78.27 RCW and <br /> 296.200 W�C. <br /> � "' � <br /> , i- zr -09 <br /> S�,na Date <br />