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� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES S �`� <br /> 3200 CEDAR STREET, EVERETT, WA 98201 -3 <br /> 425-257-8810 - FAX 425-257-8857 -www.everett�va.org C�3 p 5•.16 "�( <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � <br /> �, (,�(��L� jt/ 1� ( / ���, .S�-, , �� .�2 U� <br /> �� 7 Y� d!/� i/c' r � <br /> PROJECT ADDRESS <br /> / �(��'C3 /U J S�n � �c %G' L- <br /> > � .. 7�" 1,v/} `���.,2�� � <br /> �'� 5��� ���C� ,�J� -� i � Cr< < i� �1�� �✓-< < � - <br /> Owner Mail Address City State2lp Phone <br /> � G ti�r.x ��!'u �`/lE •l7� S <br /> Tenant hlail Address Cily Slate2ip Phone <br /> �/z>`-74 � -i - �`•' <br /> `; ;�_i f-'i .' Z' /j o "r �- � �� r�,,.,, !-�✓, c, y ti h w..,� LIJ� �I.�' U� 7 <br /> ElectfiCal ContraClor Mail Address City Slale/Zip Phone <br /> ' 3 7S _ <br /> 7/n�r)��_��;'lUc�> j /{ <br /> State Liconse Number Contract Price of Work <br /> I' 1✓1 V..L f� '. .� L.'�-�c:� . <br /> /y <br /> Proposed Use of Buildinc� Conlact Person (Plan Review) <br /> Descnption of Work to Be Dono: �� � �� � " � � , lr�'- ✓ Iv w�' /i_�l h y ,a r��., �' <br /> ,� <br /> / / � <br /> �tn . - t c• , t: �. ,.� C -� . '--♦ l ✓ itn., G 17--L _ ✓�i :i ,.� <br /> � «-i ew,�.�, f � . <br /> �./�-✓ ! •J •�lM �� I �l�P <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> �,��, 7 � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certify fhat 1 have reod nnd examined this application a;id kno,v the sarno to be true and 7 'i� I j � � <br /> correct. All provislons ollaws and ordinances governing this type of work�vill6e comp/eted � � �' - l� <br /> �vhefher specilied herein ornot The�ranfinc�o(a pernut does nef rosume fo give aufhonty to <br /> violate or cancel fhe provisions olany other state or local la�v re�uPfing consfrucfron or fhe <br /> per/omiance oI constnrcfion. rhot 1 am authorized by the o�sner o(this property to perfonn�ho <br /> �vork lor�vhich application is made and 1 compty�vith fhe Sfate Centractors La�v 18.27 RCW and <br /> 296.200 W C. , <br /> l�s� ���'�.P�:� S � ��/ % i <br /> SignaWre' °i Dale . <br />