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i <br /> ELEGTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMlT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � _ a/-D� <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org �O n o '� r�� <br /> 7 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �� I�'l. <br /> ;_ � <br /> �:^_.� },i��r ,. ) � <br /> PROJECT ADDRESS <br /> �_.1�� .:� .'.' . //�l �i�l:'�! t��h j{/ ��/�- �VIT��/! WK /Cl (�.��1 <br /> �—_ <br /> Owner ' F.1:_i Adtlress City StatelZip Phane <br /> Tenunt Ltad Adtlress Gdy State/Zip Phone <br /> ew(� d��'d f�t� <br /> ��=tw ,�������;ril ri� /aaf3 Sr.� �s 7�s� avtii�rv t.�,� .'�/G�� _ <br /> Electrical Contraclor Mail Address ciry s�aterz�� Pnone <br /> 1 , ; � �l..i ..t �� <br /> Slate License Number Contract Price ol Work <br /> //��»t}. <br /> Proposed Use of Duitding Contact Person (Plan Review) <br /> Description of Work to Be Done: �O'17�V0�-T�?/C S�%F7h�l <br /> NOT[ WIRING IN NON-DWELLINGS IS REQU!RED TO FEE <br /> I 6E IN RACEWAYS, MC OR AC CABLE. <br /> � <br /> CITY OF EVERETT LOCAL SALES TAX CUDE IS 3105 <br /> 1 heriby ccrtily Ihat I have rcad and eramined fhis dpplir.a(ion and knrnv the same fo be hue and <br /> conec;. All pruvisions ollaws and oNinances grn�erning fh�s type o�u�ork will be completed <br /> whefher speci(ied herein or naL The�ianting of a pennd does nof �resunie to give aufhonty to <br /> violate or cancel C�e provisions ol any ofher stafe or locnl law regu'afing conslrucfion or the <br /> peAormm�ce oI ccnstrucfion. Tl:at 1�m�idhorized by Ihe o�vner o/fhis propeiiy(o perfonn the <br /> �vork lor �vhich applicafion is made and I coniply�rith fhe Stafe Confracfors La�v 78.�7 RCW�nd <br /> 29G200 lh�A C�- .� _� / � I <br /> _ _ / , / <br /> � ,. ' � �l/ �l <br /> - _ � ..__..___ _;�.-09 <br /> SIt�I1llUlp �..� - I)dIL' <br /> .__.___. .. _ . . .. _ ._ . ._ . __ .._ . . . ._.._". ._ _. __ __—___—._"— --1 <br />