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{ <br /> i <br /> i <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �� --g—O 'J� <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org C o sr� -0 3`� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO I PM <br /> I5 i � �P�ccF�c, n�L , ���i��t r <br /> PROJECT ADDRESS <br /> - �si� Pr�cir-ic A��� ��(�.��-r 1JJk1 `7�'zo 1 <br /> OwnOf Mail ACCreu Ciry State/Zip Phone <br /> �L1 � l ,( Vf��(� - ��I� �aC�FILAI� ��"�'TT !�} �Zol <br /> Tenant Mail AEEress City State2ip Phone <br /> �oR�l� �C�►eiC�/nK 72I AV� A S�, E Sn�oNan�H GJ�)9u�`!0 ���f�b2 <br /> Eledrical Contractor Mail Address Ciry StatMZip Phone <br /> cC������3�� .- o�>>�y-� c��� o�- zYr. �� 400. o� <br /> Slate License Number U�L�1 U��� Contrad Pnce ot Work <br /> �r,�1�K�ii��- �T�i'E �RE�mf1� <br /> Proposed Use o1 Buildmg Contact Person (Plan Review) <br /> Description oi Work ro Be Done: �N� I�u �"7 �I O�i O F O�X �l' � � ��n E �� <br /> r►X'ruK= S <br /> NOTE: WIRING IN NON•DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br /> I bereby certily thal l have rcad and ezemined thrs applicafion and know fhe same fo bo frue and <br /> cc�recf. All provisrons ollaws and ordrnances govemrng fhs type ol work will bo completed <br /> whefher specAied herein or nof. Tne granfing o(a permd does nof presume fo give authonty fo <br /> violale or cancel fhe provisions ol any other stale or lecallaw 2gu(afrng construdion or fhe <br /> peAormance o/consfrudroa Thaf 1 am aulhonzed by fhe ownnr oI this proporty fo per/orm the <br /> work lor which application is made and I cnmply wifh fhe State Contracfors Law 18.27 RCW and <br /> 796100 N(AC. <br /> �� �� � � <br /> . ,, -- ��_ i� —g_o5 <br /> _- Sign rR - Date <br /> ._.. .,_� i` �',� . <br /> �—-- ' -— � <br /> — �' -' � � <br /> _ � - � 1 <br />