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( � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 42�257-8810 - FAX 425-257-8857—wwav.everettwa.org J ��b"�� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �I I O S "fl7�'l' <br /> ��Qai c°�r���-� ���� � �;�ta <br /> PROJECT ADDRESS <br /> � � �� . r �,�,� .� ��r� ecr�,�<�,t�. c �- r� ��+�-�rY,�ci ti���1��-� ,i i <br /> p�y�e� Mail Address City Slale2p Phone <br /> 1 1 �i -�, � c �� l rn � ' j. - , N �,vc� 1 �S �I <br /> Tenant Mai�Address ciry state2ip Pho�e <br /> � � <br /> Unr�4-eC� , [�,tnC_ `��DI S �� fl�te . , �•re.t'.�.i�k.��A�- .�` �I _ C�S��'2l�ttZ� <br /> EleCtric21 ConV2Clor Mail Address City Stata/Zip Phone <br /> �� � ����v O ' `/ U <br /> sLl Nns NE�C'� 1�\ l o Conlract Price o(Work <br /> �����,E1V`�����(<.1�1-�� vJ(lYl �'�.��Q�4`� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> DescriplionofWorktoBeDone: �1\1C,�— ��`C-L-� <<-��cl �� Lkl�`���1�t—�l� <br /> �I�r���� �' u�-e n� . sri��+ �� ,^�-�uri� - ( , ���c� -�� <br /> ��r'���_1��11 /1,���-c� l�(-'-�-.{�C�l L�'��� • , 'i�''fR��f�l �� `� . <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> a-I Ln � (� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS�705 <br /> I here6y certi/y that 1 have read and examined lhis application and know fhe same fo be tn�e and � ��1 <br /> correct All provisions of laws and ordinances goveming this fypa of wnrk wilJ be completed l� l, I V� " v ' <br /> whefher spec�(red heroin or not. The granting o/a permrt does not presume fo give aufhority to (/ <br /> vio/afe or cancel fhe provisions ol any other stafe or local law regulating construcfion or fhe <br /> peAoimance o/conslruction. That I am aufhorized by Bre owner o/fhis property to peAorm fhe <br /> work lor which application is made and I compty with the State Contradors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ' �/lJ 11 <br /> �. � �� :�� �C � ,L�� <br /> Signalu Date <br /> � <br />