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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 S_S�O 9 <br /> 425-257-8810 - FAX 425-257-8857 -www.everetlwa.org E050 S'�Z3 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> /C>_7 �' .> / '��O,- S�% <br /> PROJECT ADDRESS <br /> �(�£� � /c>/'i�7 ���C'j— � 'T�°-�,� �,,,�,��� '�8:�.,,y �/Z7 -ZyO-jC'v <br /> OWner Atail Address City StalelZip phone <br /> Tenanl hlad Address Crty St3le�Zip Phone <br /> � ��,�l�� 5;,/, 5`Sn�:Ti r .3�0 iL`=vr..,�r�-e .�v�r���-z-v/ ����-�•_s`%-�/�/ <br /> EI clncal Conlractor A1ail Address City Stale2ip Phone <br /> Ft'L.�i✓�s ,-�� .�l' �� �o��� —, <br /> Slate License Number Conlracl Price of WorA <br /> , S �� .e����«��s� :r� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> �,/ i /'�" ,�� <br /> DesCriplion o(WorF,lo�e Done: <�^��i/.^� L � •;� �7z'.�— a•��//i j /T�?�i:%r: .��G7 <br /> . <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I 1 hereby certily thaf I have read and examinod fhis applicafion and kno�v fhe snnie fo be frue�nd <br /> conncf. All provisions olla�vs and ordinances�overnmg fhis type o;work rvill be completed <br /> �vhether speci�ed herein or noL The�ranting o!a perr.uf does not/�resurne fo give authonty fo <br /> vio/afe or cancel fhe provisions o/any other sfafe or local law re,qu afing construction or fhe <br /> pedormance olconsiruclion. Thaf 1 am atdhonzed by the o�vne�o!'his property fo perfami fhe <br /> work Ior ivNich applicafion is made t�nd I compty t+�ifh the Sfate Contwcfo�s La�v 18.27 RCIM1�and <br /> 296.200 WAC. <br /> �/��/ <br /> � <br /> ��/ / .�/i>� / _r-�.5'-1 j; <br /> Siynalure �a�a <br /> � a� c�5-n z3 <br />