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( <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES y..-�� -�� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �'��(y_D6(� <br /> 425-257-8810 - FAX 425-257-8857 —www.evereltwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �S 3 l3 �-t,,�.e�- ,Q.� �l r� IL�Q 1� z �/�/�� <br /> PROJECT ADDRESS <br /> �Y1,G�d� 2oZv n�,�.e,tl� v� �fi.� � ���i� ��� 9�azi <br /> Owner Mail Addmss City State2lp Phone <br /> Tenant b7ailAddress Cily Slale/Zip Phono <br /> 1/L$j 77$2SY' <br /> n'? l�t� �'�� � �i�_ � v Qo � 7—U -ri �� �10 h�,✓Y ��t'fsz P,/ <br /> E'ectrical Conlractor Mail Address City Stale/Zip Phone <br /> Y►ticl,vt.uv ���9 7!/��- �l SGt� � <br /> Slate License Number Contracl Price of Work <br /> 011S �/�— �°�� ���r} <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> Descriptian of Work to Bo Done: _,/( {l�Q �J� -� rL _ <br /> NOTE: WIRING IN NON-DWELLINGS IS f2EQUIRED TO FEE <br /> BE IN RACEIh'AYS, MC OR AC CABLE. �� C� <br /> � <br /> CITY OF EVERETT LO:.AL SALES'�AX CODE�S 3705 <br /> 1 hereby cer7i/y thaf f harr.read mid examined lhis ap�licalion and know the same to be Wo and � I���. � �b �1 <br /> correcL All provisions o.`i:+ws and o��dinances govenung ths type of work will bo completed L� <br /> whether specifir.d herein or,;nt. The granfing ol a pemnt does nof re:;umo fo givo authonty to <br /> violafe or cancel the pmvisions�l any ofl�er sfafe or local law reguPsting constructiun or the <br /> pedomiance o/construcfion. Thaf 1 am aufhonzed by the owner o/Ihis pro,oer}y fo pedomi the <br /> wak lor�rhich applicafion is madc and I comply�vifh fh�S(afe Con(ractors!aw 18.27 RCW and <br /> 796.200 WAC. <br /> ��._�h1il�-- y/�L�ZviZ <br /> StdnSture �Data <br />