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r <br /> ' 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.everenwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM T'J 4 PM <br /> .��'ZS ��uc<-'�� i9v� <br /> PROJECTADDRESS <br /> y2,> ;z2 �3? <br /> ��. c%'��%i�/'�i� .3�'d� i�y/�9� �„�Y� c�/I qd2ai <br /> Owner Mai�Aatlress Ciry Slate/Zip Phone <br /> �jc.,--L �iJ L•.�n��� <br /> TenL�rt MailAddiess City SlatelZip Phone <br /> �2vti�j�IG[�s��;�t, �.�=/a�ic»S C✓P�f'�lv.� 7��� y�>3�X� <7`,xi <br /> Elecirical Contractor Mail Address � City SlatelZip Phone <br /> SOc4N.(�? 5�I,S7z��� % � <br /> y� <br /> State License Number Contract Price of Work <br /> ��1-,,�_ <br /> Proposed Use oF Bwlding Con[act Person (Plan Review) <br /> Description of Work to Be Done� ���l/Z�� ���t ��'L✓ (/C'/'M J t� //�c'fi/^0:�7�'�� <br /> NOTE: WIRING IN NON-DWELLINGS IS REOUIRED'f0 FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br /> 1 hereby cei7dy that 1 have read and exammed B+is application and know the same to bo tn�e and <br /> correcl. All provrsions olla�vs and ordmances govemmg this fype o`u�ork wdl be cornplofed <br /> whether specilred herein or noL The granting ol a pennd does not r esume to give authonty to <br /> violafe or cancel the provisions ol any other sfafe or local law reguPtmg conslrucfron or the <br /> pedomiance oI conshuction. Tha(I am authoiized by the ownei ol tha propeRy(o pedorm fhe � <br /> wod�lor which application rs mado and 1 comply wRh the Sta(e ContrecL�rs Law 18.27 RCW and <br /> 296.200 WAC. " <br /> ��' �/iG/�c;�C �oU� <br /> i <br /> � 3fgnature �a1e <br />