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� <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-6657 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� y� � r �c �'.o-.r 1%� �VG','P_� 7U �6. � <br />PROJECTADDRESS <br />Ovmer <br />Tenanl <br />Mail A[dress <br />Mail Pddress <br />Contfactor MailAddress <br />City <br />Cdy <br />caY <br />l�{-?n n t f�f-'L 4 59Tl� �1(� � <br />State Li se Number I/�} '� I l <br />` � <br />Use of Building <br />Descnption of VWrk to Be Done: <br />Stato2�p <br />SUto2ip <br />Smto2ip <br />� )Yl�' 3.L'�.a° <br />Contract Pn , oi Work <br />Confact Peis�n (Plan Review) <br />L <br />Pl�one <br />Phone <br />Phorie <br />� �„a� �3,7v (?rr��fT�C .i�6,-r,aar� ��(ec-��rd�cd I,nur-� �-� „ l� nn�✓1 <br />NOTE WIRING IN NON-DWELLINGS IS REDUIRED TO <br />8[ IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certily thet 1 heve reed end exemmed fhis eppfrcatron end Imow the seme to be fruo end <br />correct. All pmtnsrons ollews end ordinences goveming this type o/ wark twll be complefed <br />whefher spec�6ed herein or not The grenfing ol e perrrrR do��s notp�esume to give eutbonty to <br />v�olefe or cancel thepro visions ol any ofher sfete or locel lew reguleting constmction or the <br />peAormence a! cronslruction. Thef 1 em authonzed by fhe owner ot fb�s property to pertom fhe <br />work lor vihich epphcetion Is mede end 1 comply wdti fhe Stelo Contrecfors Lew 70.27 RCW end <br />296.200 WAC. <br />FEE <br />I�� � ` `� �OC�oa-1�3 <br />J �'re,1 J7�� Cc l�aiac�,� <br />—�- <br />