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�LECTRiCAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVlCES <br /> 3200 CEDAR STREET, EVERETT, WA P92C1 ��,I�i —i- � <br /> 425-257-8810 - FAX 425-257-8857-ww,v.everettwa.org � <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �_ ` �`,-� _I I ` <br /> � <br /> '—I `- I,. ) �,-,.C,1'b-. .< �•-. /��1!;. <br /> PROJECT ADDRESS <br /> �`i,� � LcA` �y r�� � ' �i'i�,� C�'vC -� � C_1i�1 �u,'_',� -�`' �-' � , I �-. <br /> Owner h1ail Address Clly State2ip Phone <br /> TenaN �1ail Address City SlatelZip Phonc <br /> �.��V��`-�-?�Yl��l �=��_�L�1' ; Ii_�, �: �i) � � ���'_ - -i}:� 1� <br /> Electrical Convaclo� Mail Address Cily SlaleQip � Phone <br /> 1 , , _ i� I�.. ; �- � i�T/�` � �� <br /> Slale License Number � � Conlracl Price of Work <br /> Proposed Use of Buildin� Conlacl Person (Plan Review) <br /> DescriptionolWorkloOeDono: U�-7�`( Q. 'y`,�L_`-�,_:� I'�� ''� I,�iJ/ r_L-{-� �=+f�� �`% <br /> i <br /> _ -�"���-Q.-1�.�'-C-i ;�,C�, ��/1 V� C_Q _ <br /> � - <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEc <br /> BE IN RACEWAYS, MC OR AC CABLE. ��� _ �, <br /> � <br /> � CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hrre6y certily fhat 1 have read und examined this applicafion end know fhe same to be true nnd <br /> corrocL Alf p(cvisicns ollaws and orAinances goveming this fype ul r��ork will be completed <br /> irF ether specdieA herein cr noL The c�ranfin�of a perrnd does nol reswne to give authonty ro <br /> vio/ate or canccl the provisions o/an}�other slafe er local la�v reguPting consfruction cr fhe <br /> peAorntance o/constiuction. That I am authonzed by fhe o�rner ol fhis property fo perlumi fhe <br /> work lor whir.h applicafion is made and 1 comply�si(h the State Ceniracfors La�r 782i RCIV and <br /> 29G.200 WAC. <br /> i�� _ / ;, <br /> � <br /> ' � f l i- �-�� � � � 1 `.- � <br /> � � <br /> � ignaturP . —� 1 Dale . <br /> �o�;-� -� I�l <br /> --- - — --� <br />