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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVFRETT PERMIT SERVICES ; _ �� _�p <br /> 3200 CEDAR STREET, EVERETT, WA 98201 C��.2_� � <br /> 425-257-8810 - FP.X 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �'�.C;� ' j�. ��c.�' ' ,t. •t� �- <br /> PROJECT ADDRESS <br /> � , . , � <br /> (-vc"rl� I nir t�� %->I� c � ci� ' �'� r ',{ �_�..r �(}- 6_ �� `I/ .� i �if.?, .•l}`-"T'�l4 <br /> Owner MailAddress Cily � Stale2ip Phone <br /> i / <br /> . ..�� �. ..rm� ih 1��� . .t L (,'�'� i�' �>t•�:> c'_ <br /> Tenant � MailAtldress City State/Zip Phone <br /> ll �l�-."� 1��� � ��i..l '<�(� �i-n r ���f` Jr � ��� l.,%� �$1�1C'�� �ilt.� ��'Y-i7�C� <br /> Electrical�Contraclor �MailAdtlress City StatelZip Phone <br /> � <br /> _"� "�/�/C� – • '. — <br /> '[ _ A �-- 7 � <br /> ! ,'N-�:.� 5 II, �Fi`•1 {�'Y-L7l(.+ li�.c [�l <br /> State License Number Contracl Price of Work <br /> /'.1 r. 1 �. � � �r��.�_ �. ��i ililr� _ <br /> Proposed Use o(Building Contact Person (Plan Review) <br /> Descriplion of Work to Be Done: �,��•"��.• �I 1'r�� � ('�` Il+..��C 1�`, i.� _ ;r� �-„ ' �i`37�O�115 � . _ l;.'1�}'� 1'a:�� <br /> �Ti i 1� � " - t�Tl 1� `Ir � /r 'I i - �' i� 'c f- • � �- �� �)['�1 Jt��i1C�c'�-�i <br /> ,: ��'�: ��,.�, �, : I� �'t'•�, _, �� � � i � if � ��'� vn<_l <br /> NOT�: WIRING IN I�ON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACF.WAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ce�tily fhaf I hnve rend and exarnined Ihis applicnlion and know fhe same fo be fnie and <br /> conecL All Urovisions ol lnws and ordinances r�oveming Ihis typo o!work will be comP�eled <br /> whefhcr spealicd herein or noL The granfin,q ol e pennil daes not on>:wne lo give aedhonty fo <br /> violate orcance!fhe p�ovisions ol an}�olher'sfaf�orlocav/lnw regul�' �� :onshucfion orthe <br /> pe�lamarrcr, o/consin�cfion. Tha(1 am aufhonzed by Ihe owneroRm;propedy to pedomi the <br /> wwk lorwhicli npplication is made and I comply with Ihe S(ate Con:;icto s I.arv 18.27 RCW and <br /> 29G.200 WAC <br /> � �_ <br /> ��� ' � /` �� ,! �`� i���2i'!n � <br /> � ignalure Date , �� <br /> ��. <br />