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i <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 <br /> �.� APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �� � �.3—U� <br /> L-�o7c4—lo r <br /> _��11� C: /2�aFi�7f (//Y'Gv ��/`, ����_�'�<'a�'t'(� l:�JL� <P�U Z CJ � <br /> PRvJECT ADDRESS <br /> �/��F6��,-,-� i'%�f�/,.�� ��;� . �izs z� zg�3� <br /> Ownef � Mail Addross Clty Slate/Zip Phone <br /> Tenant Mail Address Cily SlatelZip Phone <br /> �c/tr// ���c�7'�C �ic . .S�LY.' 7 G°/sl����= s'r��,t;.�s�,// C�,.� 5'b�� 7c) <br /> Electrical Conlraclor M11ail Address City � Slate2ip �/z.�'8 J�;Phone <br /> ��'�',�$' <br /> W%/�TTC,z Gi y_S �%� � .30 K <br /> Stale License Number Conlracl Price of Worl; <br /> i <br /> ��S/��K�, {�� I <br /> Proposed Use ol Building Contacl Porson (Pian Review) <br /> Descdption o(Work to�e Done: �� /`�� �/�c�: ��'U<<e-�� $z•,—��« P � lJ �/'p c>� <br /> �4/( �� ,� (l�� , '�s <br /> NOTE: WIRING IN �JON-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 certi(y ffiaf I havo read ond exornined this application and kno�r Ihe sanie to be iruo and <br /> cortrocl. All provisions o/la�rs and ordinances go��eming this type of work n�ill be cornpleted <br /> whether specified herein or not l'he c�ronfing of a pemul does not presume fo g7ve authonty to <br /> violate orcancel the Provisions e/an}�ofhersfdto or local law re�ulating construcfion oriho <br /> perfomiance o/construction. Thet 1 am authonzed by fhe ou�ner o/this property to pedomi the <br /> work lor�vhich application is nmdo and 1 c ompty�vith fhe S(ale Centracrors La�r 18,27 RClh�and <br /> 296.200 WAC. <br /> l <br /> i .�/ ������G � <br /> ��.. <br /> � SlgnaWre , Dale <br /> ����_ � C � <br /> � <br />