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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.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> o�Sw�I lil eY'n"!O/�P <br /> PROJECTADDRESS <br /> O�.-� 5�c�,-o;a�, asa l L,e��..�o.�c L,,��� u�� 58��" <br /> OWnef IAail Addmss City State2ip Phone <br /> Tenant MaiiAddress City State2ip Phone <br /> .Gf.�4r ��.s 5 ��Ccl`�. c LL� /6106 .nc.Ef�o. 1Q� ������o Lv.4 �� <br /> EledriCal Contfador Mail Address Ciry State2ip Phone dY <br /> �j�is'.?�O � <br /> F�o� g�y 9�0 ��300 .�� <br /> State License Number Conirad Pnce of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Desuiption of Work to Be Done: �c0�4 �c a/� �C-�o b � 1�4�� ��7 �-IX��< <br /> i,✓i ��1 ✓fe W k1!✓� C <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 3105 <br /> 1 he�eby certily thaf 1 have read and examined this application and know Ihe same to be true and ���� i3 �' <br /> correcL All prowsons ol laws and ordinances govemrng this type ol wode will be completed <br /> whether specilied herein or nof. The granfing oI a pennrf dces nof resume to give authonty fo <br /> violate a cancel the provisions olany other sfale or local law reguPfing construcfion a fhe <br /> pedomiance oI construc(ion. 71ret i am authonzed 6y the owner ollhis propeRy to pedorm(he <br /> worN Ioi whicb applicafron Is made and I comply with the State Contradas Law 18.27 RCW and <br /> 296200 WAC. <br /> �z/�� �.� l�-� 9- o y <br /> ignaWre Dale <br />