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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 /> :� �J�-- � �� I �C.L) C_IrC� S � I I I/ �� � <br /> PROJECT ADDRESS <br /> ��C,t vt,j ��� i�b1 b �5��� �� , tx.�J C�'�S'� �vC.. �✓ �� , 1,1� f� -�i ��� �J <br /> Owner �� MailAAdresn Ciry SWte2ip� � � � Phone <br /> 3`��' " `� I S S <br /> Tenanl MaitAddress City StatelZip PMne <br /> niti ��I.S1:� l'Lc< ; ,,���DF>r � 3C jZ Ly n.�.v .,. e�9 Lun `1 ��� � � <br /> Eler�icalContractor MailAddmss City StatclZip 1�� jj 4_ � �horo _ <br /> � _� y <br /> �i �iti �; sF � c� � � r��� — <br /> Sta�e License Num6er ConVact Pdce of Work <br /> ��-� /1"�['/�� �c' � <br /> Proposed Use of Building Contac[Person (Plan Review) <br /> i <br /> Descnp6on ot Work to Be Done: �-L� �� t� ti� �1�.� ��c-�-'% �-� � '� Y <br /> NOTE: WIRING IIJ NON-DWELLINGS IS REQUIRED 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 reed end exemmed th�s epplrcefion end know the seme fo be frve and ��(,;H�- G y�� <br /> wmect. AII prowsions olle�vs nnd ordmences govemrng fhis type ol work�»II be complefed <br /> whether spealied'��rem or nof. The grenhng ol x permrt doas not pmsume fo give euthonry fo <br /> v�olefe orcencel the rovrs�ons o/eny other sfelr or locellew regwetmg consWchon or the <br /> pedormence ol consPiuchon. Thef 1 am eufhonzed by fhe o�mer ol fhis property fo oertarm the <br /> work/or�vhrch epplicetion is made end I compty wdh the Srefe Contractors Lew 1 B27 RCW end <br /> 296100 WAC. �I <br /> � ��i. 1 y " �o ` 1 � <br /> Sgnatum � Date <br /> l _ _ <br />