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( <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 � J/�� ��� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �� a- � �� �/� i= <br /> PROJECT ADDRESS <br /> �� SI �5�26 S�Y� � ��v�nv^K,�j W A c��o 2& � k84 <br /> �rnP�Czs N �c�-\ � � Fs <br /> Owner A7aii Address City Stale2ip Phone <br /> �o Z � �`�1aS�M� V �-P��� � �V�� v.�'� ��Z.Q�� `t°6A i�- � <br /> Tenanl 61ai1 Addross Cily Stalc2ip Phonc <br /> Eieclrical ConUac�or Mail Address Cily Stale/Zip Phone <br /> Slale License Number Contract Price o(Work <br /> 2 (� R�c1M}�r�n�i � <br /> Proposed Use uf Ouilding Conlacl Pcrson (Plan Review) <br /> Description of Work lo Oe Donc: 11\p�, � �f{ ,,,5,` p � , x '��0. l,l <br /> 1'�'v <br /> —��e S,-� � ��.�e,M-- � ' o , � i� �I.���� � <br /> �^^ �C.Q�.�.--'�9' �c' ��- <br /> NOT[: WIRING IN NON-DW[LLINGS IS REQUIR[D TO 1=EE <br /> BE IN RACEWAI'S, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certi(y thaf I hare read nnd caamined(his app/ication and Fno�v fhe same to be fruo end <br /> con�cL All provisions olla�vs and ordin��nces govemmg fhis fype o/�tivrk will be completed <br /> �vhether sp�ci6ed herein or noL The gran(in�o/a pernut does nof �resume fo give authonty to <br /> violafe or cancel Uie prorisions ol any ofher state or focal In�v regulafing cons(ruclion or fhe <br /> peifonnance o(construction. 7hat 1 am aidhorized by the o�rner oI fhis property to perfonn the <br /> work lor�vhich applic��tion is nt��de m�d I compl��n�ifh fhe Sfate Cen6-acfors Low 18.27 RCW and <br /> 296.200 WAC. <br /> ' /��-� �I � ' U � � � <br /> ��{7n.0.i� Uate ✓� <br /> r/ IIQI . I <br /> � <br />