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�---� <br /> ce�-sc��(y;! <br /> �� <br /> ELECTRICAL PERMIT APPLICAT <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 - DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> � � //'' � <br /> � <br /> � � � �i �'C (�� _' � �{ l� ! ' ��� . l.- �' �i ��C � ;.i.�" ,�/'� L'X �?;� <br /> PROJECT ADDRESS <br /> ���� ,�c�u �(. /Lf � S � rr �' � J �� ��.ti�� � <br /> Owner ad nddress Ciry State/Zio Pnone <br /> Tenanl Matl Address City State/Zip P�one <br /> �- � �L� �� � ���1 n S ' /l�� <br /> �Jr"�"�'IW,1.lJ ( C �-' t.`� ;( t� + � '.•�t `li�'�— Sv'C7 �-1' � I /1�. /z.� //✓ % Gl"Q.-� 2 <br /> EleCtnCal COntractor Mail Address �tty Slate/ ip Phone <br /> i�0 � � I C l �� �c , � O , UO <br /> Slate License Number Conirect Pnce of Work <br /> � -� J + GI� -� rC -i' �� f� l�l f� f �1Je �'L <br /> Proposed Use of Bullding Contact Person (Plan Review) <br /> Descnption of Work to Be Done: � � l,�l/ � �� -� -(� ' C Y � f ( ( � l '�"' � � � �� ��- <br /> � �� /-�-m � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br /> 1 hereby certily fha(I have read and examined fh�s apphcation and kno�v the same to 6e true and <br /> correct. All provisions ollaws and ordinances govermng this type o/�vork�vdl be completed <br /> whether specified herem or noL The gran6ng ol a pennR does not resume fo grve aufhonty fo <br /> violafe or cancel the p�ovisiuns oI any o(her state or local law reguPtmg construcfion or(he <br /> peAormance oI construcfion. That 1 am au(honzed by Ihe oa�nero;fhis propeRy fo peAorm the <br /> work lor�vh�ch applica(ion is made and/comply�vith the State Confraclors La�v 7827 RCW and <br /> 296200 WAC. <br /> � <br /> �� (i i /��.�ii. )2�.�_ ��,.0�,;��(�( � , � " j �j `Li � --- <br /> —�ignaWre ,- I oate <br /> / <br /> � ���, �J/� <br />