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i <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDRR 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 /> /�U� �/���i�� ��r'/�/�,-., � ��l.Y�' �� <br /> PROJECT ADDRESS <br /> �/' ,U��J r7(. 9: ���/-DI '/U={/'�o� l,.� ��;,-/8 �,5�� 9PD3ro �I`,,t7JJl�1l�-Y��� <br /> OWner A1ail Address City Stale/Zip Phone <br /> Tenanl Mail Address City Stale/Zip Phone <br /> �2��ti,_ �r•z f ��.� . i����' �a���>�y ��� �����,� 9��1 ���'���- ��� <br /> Eiectrical Conlraclor Mail Address City State2ip Phone <br /> /J�LI/�iJ _F�o�� � �oa`=, <br /> Slato License Number Contract Price of Work <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Description of Work to Be Done: �/1 .�C�c.:�';�'_ <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 certily Ihat 1 have read and exarnined fhis application and know fhe same fo be true and <br /> correcL All piavisions oUaws and ordinances governing thrs fype o/work will be completed <br /> �vhether speci6ed herein or not The grantin9 0(a pernut does not resume fo give authonty to <br /> violafe or cancel the provisions o/any ofher state or bcal law reguPting construction or the <br /> pedormance of consfrucfion. Thaf 1 am authorized by N�e o�vner o/fhis property to perlomi the <br /> work(or which applicafion is made and I compty with the Stafe CoNractors Lnw 18.27 RCW and <br /> 296.200 WAC. <br /> � � F / <br /> , c 1 - - a � -//-CS <br /> Si nawre Dale <br /> Easrc-v �q <br />