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� � . <br /> r--- <br /> I <br /> � �LECTRICAL PERMIT APPLICATION <br /> CITY l�F EVI=RETT PERMIT SERVICES �/� <br /> 3200 CEDA;2 STREET, EVERETT, WA 98201 � O " �6 , <br /> 425-257-8810 - FAX �25-257-8857—wvuw.evereriwa.org ���/��,7/ <br /> t <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 71 � �(• . /t-C/v12 i/�- vlE�•r✓ t�/Z •,:v�2.j i U�/� �'1'1�z 0 1 <br /> PROJECT ADDRESS ��7��,73 -��� <br /> �u� � H� �� ('� �b x � � � � �ho �,-�u.._ ,,,,�- �,��ti- r <br /> p�ypg� Mall Address City State/Zip Phone <br /> Tenant Mail Address Ciry StatelLip Phone <br /> OY'.�.J J�� i= <br /> Electrical Conlraclor Mail Address City State2lp Phona <br /> Slate License Number �ontrect Prfce ot Work <br /> �,t_c � n�K- � <br /> Proposed Use of Bulldfn Contact Person (Plan Review) <br /> DascripQon of Work ro Be Done: zr �r��d��,�Ow�✓� �'lJr W°�'l` (s"'� '�-�'uc'��0/� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO �E <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ��1 1 <br /> 1 here6y ceAi(y that 1 have read and examined ihls appllcation and know the same to be frue and �(�1 V ' ��-l <br /> correct. All prvvislons ollaws and ord(nances goveming fhis type ol work will be completed <br /> whether speci(ed herein ornot. The granting o/a perm�t does nofp resume fo glve authority to <br /> violafe or cancel U�e provlslons olany other state or local law regulatlng conshucUon or the <br /> performance o/constructfon. That 1 am authorized by the owner of thls property to per/ortn the <br /> work/or wh7ch applfcation is made and I comply wifh fhe State Conhac(ors Law 18.27 RCW and <br /> 296.200 WAC. <br /> - �<i`� <br /> `� lo � � � l0 <br /> ignature � Date <br />