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C L`-�{�C'-f��� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 7�� urr � r R ; �:�,,,� R�, <br /> PROJEC7 ADDRESS � � t ,� + ' <br /> y <br /> P� � I S� `� I(� ': � ��' A �� W � lOZ L�.v�ulcc�Q Gci,g�/—ySU �(: 42s�77s_Y�. -Y <br /> Owne� ModAEdress Ciry Stato�Zip Phone <br /> Tenant Mail Address City Slate/Zip Phono <br /> �a��'., CL� ��'c P�. �oX IZ,L'_.6$ /Yi'llCr��1C W,•a/�1,��)SZ 42S' SUS• 0971.- <br /> ElecNeal ConVacbr Mail Address City �—�State:Zip Phono <br /> �P r ;P i O G E �"1 E � _�y DU '(�. CU _ <br /> State License Number Contracl Pnce of Nbrk <br /> RN; i�fa .��'�L, /al�.� �r�_r�'n� <br /> Pmposed Use of Building Contact Person (Plan Review) <br /> Descnption of Work to Be Done: ��aIu� ' �Aµt� �V U �u -'I I� 'v� I 11/. I �16��� � <br /> 1� S t��4T <br /> � <br /> NOTE: WIRING IN NON-DW[LLINGS IS REDUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> I hereby certily fhef I heve read end examinedfhis eppbcehon end know fhe same fo be frue and <br /> rorrecL All provisions ollaws end ordinonces govemmg fhis fype of�rorh rvdl6e mmplefed <br /> �:hefher specrhed herom or noL The grenting oI a permd does not presume!o grve autlronty(o <br /> v�olefe or cencel the pmwsions oleny ofhersfele or locel Inw reyu/eting constructwn or fhe <br /> peAomienro al cons(ruction. T6et 1 em eufhonzed by fhe owner olthis property fo pedorm the <br /> �.ork!or�vhich epphcetion is made end I comply wdh fhe Sfete Contrncfors Lew 18 27 RCW end <br /> 296 200 WAC <br /> � 9 <br /> �,�������.,-- ��/7��, <br /> Signn u ��� <br /> �"y-U�Q�- 1�`I <br />