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,,..--- - / 3 v � / <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERM17 SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX425-257-8857 —www.everethva.org /`— ��`�� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � ��� � —��7 <br /> c.P ��� �e ✓���1 � rPel�' Pl�w � � ,�7�� /OU ��r.0 <br /> PROJECT ADDRESS '7� <br /> ���W / tn����-Z/9 S S G L Ic�n I f S -_L �n C� <br /> �Cc,�f� ���-e s�i<< 1D,6 <br /> O�vner Mall Address —� <br /> Ciry State2lp Phono <br /> ���/✓Y�-�_ <br /> Tenant Mail Address � <br /> C�ty Slale2lp Phono <br /> y�LS 7�f3 5'70�' <br /> � ,rH���� �lP�.�'v c �soa .�, 3 s�` i9.,ti L�J L y��p G�J�4 �o �' � <br /> Eloctncal Contractor Mall qadross Ciry ' slate2ip Phona <br /> 5��/�,CE .r 9iv D 3 �6 `- (�J Sv� � <br /> tate License Number Contract Price of Work <br /> S� �� ,v Gt v�P c �/�'�—t—�� <br /> Proposed Use of ilding Contact Porson (Plan Review) <br /> �Z S — 730 ^ d�Sc�C� <br /> Descnption o(bVork lo Be Done: �G n �'C ^'- �t v� E X l-� C wn� ���� �( <br /> r �- ��/ � <br /> �( A'�TJ'� �U IO / N S�� �� /Tt /�/l O �7 0—!//�Q' P <br /> p r / � <br /> � � 1'Z i {�7 �N ✓) �'�GL� �'w /j/Vl "�. i'] C1M.. <br /> � � x -� s tiJ ,� . �;� � 6 � :,- �,1 �.�}. <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> �?•�iD <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 heroby certily(haf 1 have read ond oxnmined this applicatlon end know Ihe samo to bo frue and � I L� Q' G� <br /> correcL All provislons ol/aws end ordlnencos goveming thls typo ol work wlll be comp/oted � l � <br /> whother speciAed horein or noL The grenfin�o(e permrf does nof Aresumo to give aufhonty fo <br /> violate orcancol fho provisions ol any othor stafe or local lew regu/afing conslroction or the <br /> performence o/censtrucfion. That I am authonzed by the owner oI this property fo parlorm fhe <br /> work lor which applicalion!s mado and f compfy wifh fho Sfale Confraclors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � � � � • � <br /> Ignature �ale <br />