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� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 I� � G �� � <br /> 425-257-8810 - FAX425-257-8857—www.everettwa.org `��- ; 1/, DZZ <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ��5 ���e�� c�, R�s <br /> 4� ��._,-r`�a .�,��:_�----��;�`- <br /> PROJECT ADDRESS T <br /> '(`(�n;i�a�� C�� rn�n' ...1� '-1lu'j• `��ltiS1<<..� C�w�l{ 4In `�� ).b`� '12i • l��• Zi.^ 1 <br /> OWner Mail Address Ciy StatPJZip Phone <br /> l� �=V(�in{�:�.�� 1C V :.�L �1� �� ��IAi f NL �I.w �� ;J� :.VLY�I ` '" A IC 'tj� d <br /> f rJ <br /> Tenent Mail Address City State/Zip Phone <br /> L ; .���,,,, �_� G I:.,.I ;-; � i1�(, z �.. S,,,JC R.(. S:,il,,,t�n� (.,�r h'rLi 3 �c - Siy�y�// <br /> EleCtriCal Contra of Meil Address Crty SlateZp Phone <br /> L,:.�I.I�r `15�j C;� :'C,�� �I� . �>�� <br /> State License Number Contr ct Fiica of Work <br /> 1.-il�`- ]��1 t,I �'-"ti � '�-l'i <br /> Proposed Use of Bu ding Contacl Person (Plan Review) <br /> DescriptionofWorkroBeDone: � L��i' n..y ��Vv : ��' - � ���- �.��� �'� .��a0 �CcLs ���c e j <br /> � rl J:..'v � L e J��v � �,qr,� C <�- �l: C <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I here6y ceRify fhat 1 havP�ead and examined this application and know Ihe same ro be tnte and <br /> co�recf. All pmvisions�. ...ws and adinances govemmg this type o(work will be completed <br /> whe(her speci�ecl herein or noL The granfing ol a pennd does nof prosume to give authonty to <br /> violafe or cancel fhe provisions ol any other state or local law regulafing construction or the <br /> peAormance ol conslrucfion. That I am aufhonzed by the owner ol this property ro pedorm!he <br /> work lor which npplicafioli is made and 1 cromply with the State Contrac(ors Law 18 27 RCW end <br /> 296200 WAC. - '"' <br /> � � <br /> ! �i/ `.l-�. J� �.0 '�.CL�6 <br /> igna re �e L��� <br /> , ����� <br /> i <br />