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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8610 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCF.PTED FROM $AM TO 4 PM <br /> �J .�,y, //./z.�r1. �, z �,� (,/ ��_ <br /> PROJECT ADDRESS <br /> )(� !(J';Jd'1 <br /> , � rv r C, ✓�.c�c,���,�� /l'� "v S /�'v�fj1� .1%C .1n��_ ..�, �� ��il 9J'�j� i� <br /> Owner Mail Atldress Cily Slale/Zip Phone <br /> �/��� L <br /> Tenanl Mail Address City Slale/Zip Phone <br /> /' I / n � <br /> . 1�..��P(�/y A��r„�r,�� /��/�os ZJ-� � J��.��� � ;�t_ i�� �'��f� ���'� �� � �Gv � ��' .��y�. <br /> [leCtrical Contraclor Maii AdAn ; City Statc/Zip Phonc <br /> State License Number Conhact Price o(VVork <br /> Proposed Usr of Building Conlacl Person (Plan Review) <br /> � J � <br /> Description o(V��rk to Be Done: _ �r-�!q✓x,�i-r .,��N t?✓ � ,) � _ <br /> 7� <br /> NOTE: WIRING IN NOiJ-DiNELLINGS IS RE(]UIRED TO FEE � <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J105 <br /> I hereby certil}�thaf/have read and examined this applicalion and knrnr Ihe same to be ln�e and <br /> correcf. All provisions ol;a�vs:+nd ordinances governing fhis type ol�rork will be conrplefed <br /> whe(her specilied hercin ornot The granfing of a pennd does nof presume fo give aufhonty to <br /> violale or cancel Ihe!vovisions of any other state or local law re�ulaling conshuction or fhe <br /> pedomiance cicor,s(ruction. Thaf 1 arn authorized by Ihe o�vnerol this properly!o perform fhe <br /> work lor whic4 applicafic;i is rnade�nd I compiy with f/�e Sla�e ConU��cfors Law 79.27 RC4V and <br /> 296.200 WAC. <br /> i-- /�� i ��i�� � L <i!'� J{' <br /> '�na�ure Oate <br /> C�`,Z�/ 2 � <br />� <br />