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---� t <br /> ELECTRICAL PERMIT APPLICATION <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 /> � <br /> / `�� � G�'1�1Z�/LL C��C � �A,���ul Aj� <br /> PROJECT ADDRESS <br /> 5 S/,c� !v/OUJZt/-�oJS'' 17,t�. �7A0 <br /> rA i ,C Fi E�� �r=,���/� C.�=�,� �r' S�l aI ��� o �tL, R ziz/ <br /> Owner Mail Address City Stale2ip Phone <br /> Tenanl Mail Address City Slate2ip Phone <br /> hrF:AGs`c+�7f/f i�c�C 7��L-2za�s�� /�t�i�,�r�7 ��_f Su`�2 <br /> Eleclrical ConireClor Mail Address Cily State/Zip Phone <br /> /� c'� V 0 <br /> � ', �}-Ti�-L "��'S��l�� �ad0 <br /> % :::ate License Number Conlract Price of Work <br /> � a �-����c � ,�, .��,�itiso,� <br /> Proposed Use of Buildin� Conlact Person (Plan Review) <br /> Description of Work to Be Done: � ' L,� li.l - VU L l A�G %- S Ti9% <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 3105 <br /> 1 hereby ceriify fhat 1 have read and examined this application and know Ihe same to be true and <br /> correcf. All provisions o(laws and ordinances govemmg flns type ol work will be completed <br /> whether speafied herein or noL The graniing of a pemut does nof resume fo give aufhonry to <br /> violate orcancel the provisions ofany other state or locallaw rec�uPfing constnic6on or the <br /> perfornrance o/consfruction. Thaf I am au0ienzed b fhe owner ol fhrs property to pe�fomi Ihe <br /> work lor which application is made and I comply wifl he State Confracfors La�v 18.27 RCW and <br /> 296.200 WAC. � <br /> _ 3 _ L� _ � � <br /> SignaWre - Date <br /> , 'O G3 /CO � <br /> I <br />