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r <br /> ELECTRiCAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETf, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org <br /> APPL!�4TIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> � <br /> ,� � 1�� ��� �c'. S�-�1P� � �tv�_<<'-�_ �`L,;�C�`� <br /> PROJECTADDRESS <br /> I.�ll,�i, �I I1i: l I "��� I��� `�7hC , C�, �_;�, �_.'����-��-�1 � � ^c��;4k�['J; <br /> Owner MailAtldress City St le/ ip Phone <br /> �'n',-t�-�m���;��Pi`.'��Cl:-7. .)- <br /> ��J�I� ���� <br /> Tenpnt MailAddress City State2ip Phone <br /> —1-��m;� t����� � l� ����i�'. LLcJ . � �G :����C �f� . '1�z,�7'1I ��1�-�1�;G'U I <br /> Electrical Contractof Mail Address City Stale/Zip � Phone <br /> ��,35-'-�"��l-t,� � <br /> (�C ��� - �3�( !-L'��� l ��:,��C�- <br /> State License Number Contract Pnce of Work <br /> (�)C"���L�rl�)"1�Cf � � ����_ IYliCflii�' � l �7YYll I �'1 <br /> Proposed Use of Building Contact Person (Plan Review) <br /> �c�-4-_,`.��-.1�01 <br /> Description af Work to Oe Done: �� � - - . � — �'> <U ��'�OC� ,` c. t _ <br /> � _ , ` / �^ C ) <br /> 1� 1��_CL)I '(C . `F l•(.�1 I �C�.. �C��� �-�lr l�\ E' 1�1c��A-Y���1 �Y �1��1:1(-i �A�f�lt�l�`i� <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�705 <br /> I hereby cerVty lhat 1 have read and examined(his application and know the samo to bo true and <br /> conec(. All provisions o//a�vs and ordinances govemmg fhis type o!work will be completed <br /> whefher specif�ed herein or not. 7ho granting of a permd does nof presume to give authonty to <br /> violate or cancel the provisions oI any ofher sfate or local law regu/afing construc(ion or Ihe <br /> peAonnance ol construclion. That 1 am aufhonzed 6y fhe owner o/fhis property(o pedorm(ho ,, <br /> woik!or which applicalion is made and 1 r,ompty�vi(h fhe Stafe Contracfors Law 18.27 RCW and � _ <br /> 296200 WAC. ,�� ,� - � —� <br /> � - —� ` � �— ` . / <br /> �V � J �. 1r . �':_.. �'�I(Y�'I�`�L.� <br /> �=&ignalure � Date ' <br /> ) <br />