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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 3 _ a �_�i� <br /> APPLICATIONS ARE AG.�PTED FROM 8 AM TO 4 PM J��O j _�� � <br /> , �.} <br /> c,-c�Cc � r•��_ i�{- <br /> PROJECT ADDRESS <br /> � <br /> Owncr A1ail Address C�ty State�Zip Phone I <br /> L V��.�C'.�''1' LDMMW���-/ �� I�Cc'1L, 1Cti' K`L:l'\ �l�l'1-1� 1�. .<F �r[nt ���i, � k_.�..� .�'��+� ,,.f, <br /> Tenanl M. I Address � �_ City State/Zip � � Phone � � <br /> Q�:l- <br /> /� i i <br /> �•�l�( _I L �` C.�l iL. Ilbu �<�(l �I� ��c��.��._!�-...�.� C'_�.'l�.��" �.�/1 Ic���� f4L�� YU�' Oi�=�2_ i <br /> [leclncal onlracto� Mail Address City State2ip Phone � <br /> ��,�i� �_�� � � ��I iNA �' <br /> � '^License�Jumber Conlracl Price ot Work � <br /> C ".�Y�.V�I IL'�.I / � i�IV� ��- 11�`.1�. <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Descriplir.nofWorktoBeDone: � 1 ` f �ti�� � �� �or'- � � �.•i� -- ��-'�`i�' � •'��`�7���� �� � ���'�5 �. <br /> \ � ,,J � <br /> (� �� ` _ ' �,..... --� � Cc,��r��_�{i�r�l <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE � <br /> BE IN RACEWAYS, MC OR AC CABLE. -� <br /> SL • <br /> CITY OF EVERETT LOCAL SALES TA7(CODE IS 3105 <br /> i �_ ��( 7 <br /> I heieby certity that 1 have iead mid exarnined this application and kno�r Ihe same to be true and �✓--i�- ' <br /> c�orrec(. All provisiens o(laws and ordinances�ov�mmg fhis type o/�vo�k will be complefed ,..� <br /> whether specilied herein or noL The granting ol a permrt does nat resume fo give authority fo <br /> violate or cancel fhe provisions ol any olher stafe or local la�v mguPting consfruction or the <br /> pertornance ol censtrucbon. That I am aufhonzed by the o�vner of th�s property lo perfomi the <br /> work lor whicb applicafion is made and I comply wifh Ihe Sfate Cenfractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> . <br /> ;�=�!, �1, �__ �5�z � �_ . <br /> , , <br /> — Siynntmc — .–�-- oate ' — <br /> I <br />