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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERIIAIT SERVIGES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—�.�ww.everettwa.org <br /> APPUCATIONS ARE ACCEPTED FROM 8 AM 70 4 PM <br /> /�Ul .�/'ii/�i� ��,a.� �/c✓w '`� , <br /> PROJECT ADDRESS <br /> F/-",��v�/��o��,��.�1�� /��o/- �/d'�/-���� IJ���,,� �'�'a3� �.�� = ��o � 9t-�.� <br /> Owner Mail Address Ciry SlatelZip Phone <br /> Tenanl Mail Address Ciry State2ip Phone <br /> / //y���Ly��/_lL�/ �i�L // ✓O��/��J:J� �t�//UGl!/ ( �/Y/���/4��� ����((� �iXJ//�.J�'��lpY <br /> Eleclrical Conlr lor Mail Address Ciry Stale/Zip Phone <br /> �i�C°,{!�.�i_=�ia � .� � �� D.�'� �3 <br /> Slate License Number Ccniract rice of Work <br /> �n� /�/��ti <br /> Propose Use of Buildinc� Conlact Person (P�an Review) <br /> Description of Work to Be Done: �,L�i.,�P //f' 4) �O� /�5��C� <br /> � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> ���� '�� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily fhaf 1 have read and examined fhis applicafion and know fhe same to b�tnie and <br /> correct All provisions o(la�vs and erdinances govemmg this lype ol�vork will6e cornpleted <br /> whefher spea6ed herein or not. The granting o/a pemut does nof presume to give aufhonty to <br /> vrolate or cancel the provisions ol any ofher sfafe or local law regu/atinr�construcfion or Ihe <br /> perfonnance oI consfruction. Thaf 1 am authonzed by the owner ol this property to pedorm 1he <br /> work lor�vhich application is made and f comply with the Stafe Con(racfors Luw 18.27 RCW and <br /> 29G.20U WAC. <br /> � .�c,[ <br /> '� • � C l�J fi� /b ` / ' � S / <br /> Signature Date <br /> ���`�' D'-D�oZ- <br />