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`� , <br /> , <br /> ELECTRICAL PERMIT APPLIC/�►TIQN <br /> CITY ��F EV�RETT PERMIT SERVIC�S <br /> 3200 CtDAR STREET, EVERETT, WA 98201 �-a s-o 7 <br /> A25-257-8810 - FAX 425-257-8857—ww�v.everettwa.org � � ��6_�� <br /> APP�ICATIONS ARE A�CEPTED FROM 8 AM TO 4 PM <br /> � l�� ��� � / <br /> ��'�� li���li�>"� � �ot(.° <br /> PROJECT ADDRESS C � <br /> J�4'��'/p , �,'' <br /> ���(��,r.���'ri/, l�fr,�rl����`%�'. ,�L` ,�z�- Sh (,�)�,. ���;� � <br /> ,��� <br /> Owner � Mail Address City TState2lp Phone <br /> /Y/� <br /> Tenanl Mail Address Ciry State/Zip Phone <br /> �C G� <br /> Electrical Conlraclor Mail Address City Slate2lp Phone <br /> , <br /> ���Y� �� <br /> .f_l <br /> State License Number Contract Prico of Work <br /> /r �'U�=/��,,i';�-� ��lzlc�,- �i,t1.%�i (�'CK�1Y'i� <br /> Proposed Use of Duilding / Conlact Per on (Plan Review) <br /> Descriptiun o(Work lo Bc Done: _C�,�/��li �C��7 ��i� �i�/Z'� j�/Q�� �(�'�✓`J�I'� <br /> . ' ( ✓ <br /> �-��,:J ���F������/f l�� �' �n� �J�.z.�� �k�ir�s� <br /> � <br /> NOTE: WIRIfJG IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certi(y thaf 1 have read and exarnlned fhis application and know the same to be lruo and <br /> wrrecf. All provisions o(laws and ordinances goveming this type o(�vork wi0 be completed <br /> whefher specified herein or not The granting ol a permrt does not presume to�ive authonty to <br /> violate orcancel fhe provisions o(any othersfate orlocallnw regulating construction or the <br /> perfomience of construction. That I am autlionzed by the o�vner o!tfvs�roperty ta pedomi Ltie <br /> �rork/or which application is mado and I compty wilh the Sfafe Contractors Latv 78.27,4CW and <br /> 296.200 WAC. <br /> - 1 / .J/ <br /> _ =` J A <br /> \\ <br /> ������ ti _ � �� � � �� / � ��� <br /> SlqnaW - � y � Date � �; <br /> �t. \ ,�\ �� �o� <br /> �—_-% J----� , <br /> F o70�O �(50' <br />