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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 425-257-8857—www.evere;twa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> , <br /> � �� 2`-� l��-�� �-,�1 U�� ��,' L <br /> PROJECTADDRESS ��U S�, [��}�. ���t�1� �--�-�ti� <br /> �, �- ZOU <br /> �:uv��'��� ��e.v�C�QxSC��`1 �v�1� �,�c1� �-I�ZC%�( �yZ��'�Z� - Il �.� <br /> Owncr Mall Addross City Stale2ip Phone <br /> Tenanl Mail Addross Cily Slate2ip Phone <br /> 1 -, .- � <br /> '�1'1��� i ��1�vi I_ �C,�� 1- � � �C� �.V�� � �IZ �� ) �',�- - �-��`1 <br /> EICCUiCaI CoNraClof � Mail Address City Slatc2ip Phone <br /> ��\(_l-l� ��J C� C_.�CG "? I��� <br /> Stalo License Number ' Contract Price of Work <br /> Proposed Use of Buildin� Con�acl Perscn (Plan Review) <br /> Descriplion o(Work to Oe Donc: � v r.1 A�. �-�'�.' �`-.�-' � i'"-� � .- .�, ,Z\��_ �r� i�� J iS i INU I�ct.Nt_ <br /> � ��I< � �.�ti'��`.l� . � - '�u zc� t?MV° �`�u�AFt_'1)1) S�'i_ C,.� r �- <br /> '�4 i�v,� �.�r r�c�-, �n��'� <br /> '� :li' ��i�� �� Kl..u � iii�. 1'.h� l� �u'1ViV �ll�� .V�RiWU hS N1=iT �.l ��t�(�!`,�� <br /> �.0��._ <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br /> BE IN RACEWAI'S, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TA.:CODE IS 3705 <br /> 1 hereb}�certily(hat 1 have rend and exnmined(his application and know the same to bo true end <br /> conuct. �111 provisions ollaws snd ordinances govemrng lhis type ol work wi116e complefed L �'�l0`�'1��.3 <br /> whetlier spealied herein or noL The c�ranting ol a perrnd does nof resumo fo give authonry to <br /> violatoorcancelthe provisionsofanyothersfafeorlocallawreguPtingconsWcfionorthe <br /> pe�lom�ance ol construcfion. Thef I am authonzed by the owner o�this property fo peAomi the <br /> �rork for�rhich application is made and 1 cornply wifh fhe State Confracfors Law 18.27 RCW and <br /> 296.200 11'AC. <br /> / I � �` L%C� <br /> ��'/; .-f� � / F �� , ' <br /> . ignalvre / - .._ Date i <br />