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i <br /> ELECTRICAL PERMIT APPLlCATIOIV <br /> CITY OF EVERETT PERMIT SEkVICES <br /> 3200 CEDAR STREET, EVFRETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARCS ARE NOT ACCEPTED <br /> > .�. ,�. � ' ��� �� es 5� <br /> PROJECT ADDRCSS <br /> �/�t 5— <br /> ���� � �sy��c �le�:�>�,�,; y�GlS 1 1 � ✓"� Nr /���I< I•�� �� �a, `��033 ka.2 =SYvy <br /> Owner Mail Address Ciry State2ip Phone <br /> Tenant Mail Address City Slate2ip Phone <br /> .��lo�,s ��.�o��, �ow,-C, � l.� �d/3va �S� S�y,�wa w4,sf.�qss�2 i3 y��-)sv53�s <br /> Electrical Contracto� Mall Address City State;i�p Phone <br /> .S��Wr� ���� l� �I �DOd �. <br /> State License Number Contrad Pnce of Work <br /> K.�,5 — <br /> Proposed Use of Building Contact Person (Plan fteview) <br /> i n a <br /> Descript�„n of Wort:to Be Done: �F W �'C h Q u ��� ���F`�Ol r o�� � 1',`�"�t ��o o�„ . <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> �:ITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> ' I r,ereby cerlrf;that I nr�vo-re�d and examined this apolication and kncw the same fo be true and � <br /> i �crrea. All prov�srons o/laws and erdinances goveming fh�s type ot work wdf be completed <br /> , �t-nefher spec:6ed hereir or ncL 7he grariing o/a permit does not presume to give authordy to � <br /> � :iolate or canr,el ihe provis�ons ol any other state or local law regulating constructon or the , <br /> paformance ol construction. That/am authonzed by fhe owner or this property to pertorm the <br /> ; werk Ior which application is made and I compiy wdh the State Contractors La�v 182� ,4CW and <br /> I 296200 WAC. <br /> ' � .�,., �. w'�__ /,� - o e -- � y � <br /> � <br /> Signature Dare <br /> � <br /> I � � � <br /> �. <br /> ,�I l - � <br />