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� �- <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES ' <br /> 3200 CEDAR STREET, EVERETi', WA 98201 I',� <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED PROM 8 AM TO 4 PM <br /> � <br /> v <br /> I 31 y- Il"i ti:�'.�,�v e �;��-w� I�r�. <br /> PROJECT ADDRESS <br /> � <br /> l��a����tiai�— l:1�=>SI�fC� GLC: <br /> O��ner �1ailAddross City Stale2lp Phone <br /> Tenant A1ail Address Cily State/Zip Phonc <br /> . � ����ZVv' ,-�cYL-cy <br /> ��t.4S��1�t� I 4�t,�i�� L�L=( L�L. �c� (- i.ri<<= �'[� CE�-,"�t�J�Sc.a�a S,�2d-z <br /> Eleclricat Conlractor Mail Addrass Cily S�ate/Zip Phone <br /> �1+5%�C-"�r'4'yiZD �� l�,c'x�J,�� <br /> Stale Licenso Number Conlracl Pnco of Work <br /> ��c rJ !�' � <br /> Propos d Use of Buiidinc� Con�acl Person (Plan Review) <br /> Doscriplion o(Work l0 13o Dono: ✓r�L��ll/ (.f/)l-Cj�llllG//U'n� ' �U' 1) ��=� <br /> , [ � . <br /> (-�(�c �/�JCii L- G(J�/Ci�n/ �) �.�[) /t"1:���7 ' C'<4=1-� -1 [���- <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> E3E IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily fha!1 have iead nnd exarnined fhis applicefion and kno�r fhe sarno fo be fruo and <br /> conect. All provisions of laws and o�dinances govorTung fhis type ol work�rill be cornploted <br /> whefher speafied herein or noL The�ran(in,q ol a pemut does nof resumo to�ive au0ionry b <br /> violato or cancel fhe provisions ol en}�other state or local luw reguPting construchon or the <br /> perfomience o/consfniction. T1iaf 1 am eufhorized by the o�rner o(fhis property fo peAomi fhe <br /> work lor which applicnfion is made and 1 comply nifh the Sfafe ConUacfors Law 1827 RCW and <br /> 29f.200lNAC. � <br /> r' <br /> i �;, � —7 <br /> '���. ii'V � � �-�L<- 7 � -' �/ <br /> —� SlgnaNre � Dale <br /> / <br /> , ;:v�c�3 -I5� <br />