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ELECTRICAL PERMIT APPLI�ATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EV[RETf, WA 96201 <br /> 425-257-8810 - FAX 425-257-8857 -wvnv everettwa.org �D-.pC(-/z <br /> APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM L�Z/I�"�-C/ <br /> //D � �1'uc K� r � ve i=vP�e� c� � �r�ao I <br /> PROJECT ADDRESS <br /> Mi k�e sa��j� <br /> OwnCf hlad Address City State/Z�p phone <br /> Tenant Atad AdCress Cdy Stale%Lp Phone <br /> �pc�/�iz `i �=c��i c /3b'US //t" �v�' /�! �_. ju/�,�/� c,�-s/� S�.� t �— <br /> EledriealCoMraC�or �btaJAddress Cdy SlalelZip rC�z$"� -���/ns � <br /> l / <br /> �v� Pdu��=%�_� 99�io � �sce �, <br /> S�ate License Number Conlracl Price ol Work <br /> St' 1� — <br /> Proposed Use of Bwlding Conlacf Pcrson (Plan Revle�v) <br /> Square FooWge(It msiAential new construction, remodel or addihon) <br /> Uescriplion of V1'ork to 6e Done: _��U�� Q a ��� .�"����1 __/�_l�� �����. __. <br /> � ! ^ <br /> _/� f���c� fa� L.� ��r�� . -- <br /> NOTE: WIRING IN NON-DWELLINGS IS f2[QUIRED TO P[F <br /> DE IN RACFWAYS, MC OP.�C CABLE. �� Ol� <br /> � <br /> CITY OF EVERETT LOCAL SALES T,1X CODE IS 7105 - - - -- — <br /> I hereby ce�idy�hal l havr maJ:md eremined Ihis applicalion and know fhe same lo be hve and � I�� � _ f`n O <br /> cormcL All piowsions o/la�vs and ardinances govemrng fhis type o/wori��v.�ll be compleled U � <br /> �vhefher specrlied herein or nof. 7he�ran6ng o(a prrnu�does no( �msume lo give aufhonty to <br /> violafe or cancel fhe prnvisions o/ony olher s(ate orlocal lo}y regulnfing conslruc6on or fhe <br /> peRormance a/consfrucfion. Th,�t I sm aulhonzed Gy fhe owner o!(lusp roperly(o peAorm Ihe <br /> �voifc lor which applicafion rs made and I compl}��sdh(hr, S(ale Confrcc(ors Caw 78.27 RCIN and <br /> I296.200 WAC. <br /> __ . _�--��-�-a����r Z_ <br /> i ��S�ure —�� Date <br /> � <br />