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( <br /> ELECTRICAL PERMIT AP�LICATION <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 -DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> y I 0 � O P�I����— <br /> PROJECT ADDRESS <br /> ��Rrr1 ;R�-��r�n 3 �� � o��s E�-��- °�ga��'�'��33°► -33� � <br /> Owner Mail Address Ciry State2ip Phone <br /> Tenant <br /> Mail Address City Stale/Zip Phone <br /> NA�h��^, r�'�F 1 , � �•,C I 1 I`I��h S! �v w �'1A��cS��f)e t,�A �1�a 7 1 _ <br /> Ciry T Slale/Zip Phone <br /> Electrical Contrector Maii nddress � �)�o <br /> � (DJ (oS � <br /> ��D�� ��� � C :.ontract Price of Work <br /> State License Number <br /> Proposed Use of Building Contact Person (Plan Review) <br /> DescriptionofWorktoBeDone: �le1� C`1 �'CS1� h�' "S'� ���hr���" ���y� �� <br /> N� w Cu.,.Q� a �- Cu��lµ< IU.; c � � N�.�,.. s-�.,�Y,—e <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWA`(S, MC OR AC CABLE. <br /> CITY OF EVERETf LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily that 1 have read and examined Ihis applicatior and know the same to bo We and <br /> correct. All provisions ol laws and ordinances governmg this type of work will be completed <br /> whether speci6ed herein or,noL The granting ol a permd does nof resume to,qive authonty to <br /> violafe or cancel the provisions o(any ofher sfate or local/aw reguPting consWction or fhe <br /> peAormance o/co i��a�o^°s made and 1 cumply w thyfheeSfale Conh�ctorspLaw 18 27 RCW end <br /> work/or which app <br /> 296.200 WAC. <br /> � �� _ <br /> ignatu _ Date <br /> �c��07"�3 <br />