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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES S ���_6� <br /> 3200 CFDAR STREET, EVERETT, WA 98201 <br /> 42P �57-8810 - FAX 425-257-8857 - www.everettwa.org �d�QS�-1 �j <br /> � <br /> APF'�.i:,i,�InNS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> i !� / <br /> � <br /> � f �" � L c3. G�l C�,'"C L L L'%L,lli�l�(r, <br /> � <br /> PROJECT ADDRESS <br /> / i <br /> /.� � � �:S <br /> � ) / <br /> j�����li"�i i Cry(.•'t/ /1'�fl r � l' L � �n��/iri��/� C�NL'�� �(�i.��� ��✓�� 1 L�i'.�l Z�h4'S'f'�� <br /> Owner t.lailAAdress Clty Slate2in Pl�one <br /> Tenanl A1ail AAdiess City SlalelZip Phene <br /> n Lt� �J h..:( <br /> [lec�rical Conlractor F.fail Addiess City Stale/Zip Phone <br /> 3lale License Number Conlracl Price ol Work <br /> rT . <br /> Proposed Use of Building Contact Person (Plan Review) <br /> � � /� <br /> Description o(Work to ae Done: .' ��� i''-:' '=E /t�[ ��.� / �-� ����' � � �r/�✓i c l /i!1 i✓(��-� <br /> �•�� �,.-;-`�/, f rJ .�[" � /%''%I� S-i/�E/�1� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, A-iC OR AC CABLE. <br /> I <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> : c � <br /> I herehy ceAily Ihal 1 have read and exarnined tftis ap��licafion and knrnr the same to be tnie and ��-f�.0 J - � �"� f <br /> conect AH provisions o/laws and ordin.�nces�overning thrs 1}pe oI�roih will be completed <br /> whother specdied herein or'noL T7re granting oI a permd does nat nesinne fo�ive aufho�ity lo <br /> violate or canccl(he provisions ol nny ofher s�ate or local iaw regul.3ting construc6on or the <br /> peAurmance oI consfn�ction. That 1 am authonzcA by the o�vner oI this propert}�to perlonn fhe <br /> woik lor�vhich application is maAe and I canply�vith the Sfate ConUactors La�v 18.27 RCW and <br /> 296.200 l4�AC. <br /> ! :L <br /> � � -� ��/�.% l �-�—_� c7 . �]�_��'/� ' '� <br /> L' � <br /> •Sic�nalwc — -- U;ile^ � <br /> I <br />