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� � c � <br /> .� � <br /> � <br /> ; ELECTRICAL PERMIT APPLICATIOf I <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � � �' �' i le �r� �/ ��cc �Z �����7 �> (d�� . / ��U <br /> PROJECT ADDRESS f <br /> p / C,� � � � Acl �� c /�� <br /> �e>,ti.«ti � u % .� C L LL S i.,,�,,.�/,L, z i��i4. q 81 h C� <br /> Owner� Mail Addmss City State/Zip Phone <br /> -� / ,�/ C.-N�C t.�` i � I�1N �V�[\hf\dN <br /> � � �^ ..o C- �L}l"� /7�rri �� P�r��v IS �•r.-c � • �ZS- 7S�l-�Y7,2 <br /> Tenanl � Mail Address -� Cily State/Zip Phone <br /> � s���� � S'� 7�l�- <br /> S , . '/r � ��r� �� c q -� r�/ L.cs h � �e � �'7�'D�'7 �f2)- 9➢�f <br /> Eleclrical Conlraclor Mail Address Cily Stale2ip Phone <br /> l� �� C fJ <br /> � � �V���` <br /> Slale Llcense Number Con�Price of Work <br /> / '7- e � P�. L' ���. 5 <br /> <-`� �j �' �- i ,; Giv'� `tiuc� S � � iJ(� � y)S — OaGf <br /> Proposed Us o uildin� Contact Person (Plan Review) <br /> Description o(Work lo Bo Done: �h ) / �t( / `1 �� � "" � �Q �� V d �f <br /> //� i. <br /> � i !^ c_ LL 1 � (��/�� L7�'LG-i' � / S C Li .n v� -t' c.. <br /> 7-� r C' % , J �S �.�� � �l i �-. �-r <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CADLE. J _� ,,-,l <br /> ((J �V <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I he�eby certi(y that I have read and examined fhis applicafion and knotv tho same to be frue and �I � /' Cr ,( c�� <br /> correct. All provisions olla�vs and ordinancos govemmg fhis type ol�vork will bo completed �� ( J <br /> �vhefher specified herein or not The granting o(a permd does not prosume to give uufhonty to <br /> violato or cancel thoI�rovisions oI nny ofher slafe or local la�v regulating consWction or the <br /> perfomionce o/construcfion. That 1 am authorized by fhe o�rner o/this property fo perform fhe <br /> worklor which application is made and 1 comply�vifh the Stnte Centractors La�v 18.27 RCW and <br /> 296.200 WAC. <br /> � � � 7 <br /> �-�_� � � 9 ' ���L`�l i�'�� <br /> Signaturo Date ' <br />