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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 �Z_�� � p 7 <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM! �=O 7/ Z-OS� <br /> 171 U > > Y� , � l/;'�=✓ �� i��; G- <br /> L / <br /> //t; G :, �•li - , �L/,� j� �ii. 1.' Lq/r1 �� t'- c' � <br /> PROJECT ADDRESS � � l <br /> :.l•�/.?C' - - - "7"1� .r,9 `i�.• ��<�.-1' ._ ,� , .� ' :� ., ��_. I <br /> ='•��• �L� �'� � - �=, , > SN�.ttlr , ' l✓y `�y�.fr,� .2��G -:1�'33'- .> ���c <br /> Owner ldail Address Ciry Statetip Phonc <br /> l�'r'� - �-r i: r � ' ( �.'7 �V /1 C 7 ('.'7cl ✓ ' �_. <br /> Tenant MailACiross Ci'y State2ip Phono <br /> C � . �. ,-3• c;�� I � `;i ,.�. <br /> � . �i, �� LJr�� r�-� c� 7/� '-f�� �n h'� �2/� � <br /> � f ]5 ' � I � 'T r%{. <br /> Electncal Con�2ctor Mnil Adtlress CM Stale2ip Phone <br /> (� /.iL' i L L' J "i 3/1'6-' � i3`/. �-< <br /> Shate License Number Conhact Pnce oF Work � <br /> ��f � � .. 0 � 4�' :+ Y'C /'lc ✓5N 6 : C�/� ( �i <br /> Proposed Use of Building Contad Person (Plan Review) <br /> Descnption of Work to Be�one: �� �� � J! -' .-r, c� , � �C�O�, r - '<�7 . <br /> J / � — <br /> a <br /> _rJ�" � c: �.- 7. i-�... Sr.' r , � �� �-. � :.�, . J� c� -�i /7c <br /> t.)",/ "J 1' I Y <br /> NOTE WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> �'�"� `i�, ' � <br /> "� , <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certdy fhaf I have read nnd exammed fh�s appi�cafion end knmv the same to be fn,�e end <br /> correcL ANpmvis�ons o�la�:s and ordinances goveming Ihis type of work ivill be completed <br /> �:�hefher specified herem or not The granfing o(a pa.md does nof presume fo oive eulhonty M <br /> v�olefe or cencel fhe prow��ons o/eny other stete or locel la�v mgula6rtg consWdion or fhe <br /> performence o(construchan. Thef!am aufhonzetl by the on•ner olthis property fo pedorm the <br /> �:-ori�(or wh�ch epp6wfion rs made and I comply with fhe S(ate Confractors Lae�18.27 RCbV and <br /> 296200 INAC. <br /> I �.� <br /> —< - I' l - <br /> 'at' � � c" �- L� <br /> Signature Datc <br /> to� ia -u5� <br />