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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 42E-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �� -/O •-O�� <br /> . l '�' l- _ - c-6��5 -o6y <br /> , �. _ - <br /> _ � � S � i ��1 `.i,. �l� l' i �.�1� 1'�,:� <br /> PkOJECT ADDRESS <br /> `-^ ! ` � �r_�.:.- ' +"� �' ��� �+ "� - '�� <br /> ��11� V���j- �� _ . �.Ra �. -,i .. I i Y ti-, "iSSCJ � } <br /> Owner 1-��C�.j,�;�'t{ Rtail Address ,S�!Ii L= �I Cf Ciry State2ip Phon�Zy, <br /> n <br /> Tenanl Mail Address Cily Shte2ip Phone <br /> � <br /> F�� <br /> ��� �����'l� SZ�:'._ ��ri. �.. ���-��,e_"''�'� L�J?r `��� 4'r.-'-��—�':��}- <br /> Elect�ical Conlraclor Mail Address Cily Stale/Zip Phone�-5 � <br /> �'-'�"', e-�-�.�_ `��I l�(� � _>=,�Co = <br /> �-4�_ <br /> Stale License Number Conlracl Price of Work <br /> CC,._�C:Iti"ll,L'l �;L`�'j :�;,1�ItiE aci�', ��Ct. <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Descriplion af Work to�e Done: ��L�t-�� '-�C�1L � ✓��-v�� �� (o �--'s-2� 5 <br /> -����.� �� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FFE <br /> BE IN RACFWAYS, MC OR AC CABLE. <br /> � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily Ihaf I have read and examined Uris applicalior mid knoiv fhe sarne to Ge frue and <br /> conecL All provisions ollaws and ordinances goveming this type ol n�ork n�iAbe cornpleted <br /> �vhether specdied herain or not. The g���nting ef a pernuf does nof resurne to gi��e aufhonfy to <br /> violate or cancel fhe provisions ol any ofher sfafe or local la�v reguPfing construcfion or the <br /> peiforrnance o/caistruc6on. That I am authonzed 6y Ihe owner ul this properiy fo perform the <br /> work lor which appliqation is made and I comply wifh the Sfafe Conlracfors La�v 18.27 RCI��and <br /> 296.200 WAC. �1 <br /> �' J <br /> �-��;;�-`'��' ,1{ `':��� �"�- � �.��7- <br /> / �Slgnalurq�`. Date .� ��� - / � <br /> J �� <br /> / <br /> I <br />