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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 � `0,7`�� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> C� oa� -oaCp <br /> ��a� ai►�rn�a ��k, ,�r �+-, � �t <br /> PROJECT ADDRESS <br /> �iti.�- �. &re.�e�-4- 3�o t CQdar'St' , 6�re..re.l-E- v�a G2�o l C�)4eto- <br /> p�y�e� Mail Address Ciry State?p Phone <br /> �e,�,�. �- ;u. «.o�t Ca1�SaY-ri�a � ��, W� q82ot c.4�s)�eeb- <br /> Tenant � Mail Address Ci�y Sta�e2ip P�one <br /> ��� . �'oc�r1 i531.Q Tv�a�kon �Ave�, �"Z'-ac'�C:c, , wA Q8� <br /> EleCtrical C t2dor Mail Address City SlatelLp ��p�P�hone <br /> C4JSJ"�Uo"d� <br /> Ih�u - �G i�-�vF �/�/� '�` �+, 4�0 � - <br /> State License mber Contracl Price of Work <br /> l 11MtV�a_XCI� 1,�6(1 �� <br /> Propased Use of Buiiding Contact Person (Plan Review) <br /> DescriptionofWorkloBeDone: �IfY_. �3'C�(�fl �.� ��n� `�"e���= '—"`L'� <br /> �R�YlC. kb �l f`E�'�� �y���O�P `L�bYI �Q`l.a1C' -�. <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 J105 <br /> I hereby certi(y thaf 1 have read and examined this applicafion and know the same to be true and <br /> correct. All provisions ol laws and ordinances goveming fhis typa ol�rork will be completed r I I�,�— 07/ <br /> whelher spec�fied herein or not The granting ol a permR does not presume to give aufhonty to Y �(� �Cl� <br /> violafe or cancel the provisions o(any other sfafe or local law regulafing construction or the S� <br /> perlortnance o/const�uction. That 1 am authorized 6y fhe ownero/this�roperty to peAorm the <br /> work Ior which applicafion is made and 1 comply with fhe Sfafe Contrac(crs Law 18.27 RCW and <br /> 296.200 WAC. <br /> � �-/o� �(0 <br /> Signalure Date <br />