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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVEREI�T, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -ww�v.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> '- �.),Ij �I(� `Z C>'j <br /> ''j � Z�° I��oL-CN����� ��" �� �v��-`r� <br /> PROJECT ADDRESS <br /> �1 Z'�1 <br /> K �;� 1�( ���.��k�sr-� �IuzB K�x�,�o,.� p� . i�.x«� <br /> }I- t��.q �1��2��S ��4- 7e�S <br /> Owner A1ail Address City State?ip Phone <br /> Tenanl A1ail Address Cil� Stale.�Zip Phone <br /> �ZS) <br /> n =� C��Li2+L _�,.X _ Z�j'ZS I)2�Y" PC ,5t ��r�c �F �'�-:�1 ��2v�'- �,�c-�--439�1 <br /> Elecirical Conlraclor htail AdJiess City SlaleiZip Phone <br /> � �,�ti� <br /> Z7 '��Lt:3C�}Sb1��l 5�t� -- <br /> S�ate L•,cense Number Conlracl Price of Work <br /> Proposed Use of 6uilding Conlacl Person (Plan Review) <br /> �L'.i.'J�CL U, �:Cd't- ILC)A �JJ ����\'� � �/- <br /> �escriptio.i o(Work lo Oe Done: {�. Y� <br /> Nr_ ` ' l('�'; I�C�e �- pr�rti' 1 ' ��1���)C; 2 I��l�l�n 2t:�r1 � ZuJ c;�cv,lJ <br /> -. <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAI'S, MC OR AC CABLE. <br /> � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> i <br /> I hereby ce�lily fha,�I hare raad and exam ne.1 this application and kno�v the sa ne to be tr��e und l�(� i � C'" �<�• <br /> con�ect. All provis�ons clla�rs and erdinanccs govemmg this type o/�verk�vill be completed <br /> whe0ier speci(ied herein or nof. i he pranfirt�al a pennd does not resuma !o give authon(y fo <br /> violate er cancel fhe F�rovisions o(any ot!ier slato or local lau�reguPfinc�ccnstruction or fhe <br /> peAormm�ce oI cvnsf�•icfion. That 1 e�rn authorizeJ by the oaner o/this pmperty fo pedonn�Be <br /> wo�k lor which applicafion is nr3de and i compty�vifli the Sfafe Conhacfors L,.aw 18.27 RCN and <br /> 296.200 WAC. � . <br /> / <br /> � � �.�•` � .�� � �Zt� '�' (�� � � �� � ' 2���� <br /> - Signatine — . - D�,:�e <br />