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ELECTRICAL PERMIT /�PPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CE�AR STREET, EVERETT, WA 98201 S �a� —D 7 <br /> 425-257-881/1 - FAX425-257-8857—www.everettwa.org /07p5 •..��C� <br /> L <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � i � ' -i f"v� % i {� <br /> � ' � \ <br /> I � �� � �i 1- �'( <br /> —=� <br /> PROJECT ADDRESS <br /> _ �' j� , <br /> `� i `< �I� ���� ��� � C `'� ` > .7 � �����v�: ,i r,. � <br /> -� _ � ��'v�� �i�'1 r .�,� ���� ��'�� U � <br /> Owner Mail Address Ciry Stale/Zip Phone <br /> � � � i <br /> _�� ,����� i�;--�� � C 1 ���, � <br /> Tenanl Mail Addross � �(�,� �ly�' �� Stale/Zip Phone <br /> ] I � + w���' `����'0 > "� <br /> ��V�Y� ��- � 'C_C_ ���'� � �—/hnul0ec� � ��,)�� - / <br /> Eleclrical Contraclor Mail Address %^ Ciry Slate/Zip Phone <br /> `)"��r.v�V� �r L- �� '-, � � .�� — ) /] �') �-� <br /> ( <br /> Slale License Number � Contract Pri e o(Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> 1 <br /> � <br /> Description o(Work l0 6e Done: ���� �� � ��1��./U � � �� 1�' �� �� >` 7 ���I t-�-_ <br /> -� � � <br /> _,�-� ; � , �� � �l� , vw - -�Z� �v.�V 1/1'1`� G��'� 14�' S �'Z-d i� <br /> I <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> E3E IN RACEWAYS, MC OR AC CABLE. <br /> �, — _ <br /> G�-'J <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceriily tliat 1 have read and exarni�;ed this appfrsa(ion and know the seme fo be true and <br /> correct A/l provisions ollaws an�i orrlinar.ces�overnmg this type ol work �vill be completed � �, <br /> whether s��eci(ied herein or noL 7he granting ol a perrnd does nof presume to�ive authonty fo � <br /> violate or cancel fhe provisions o/any ofher sfafe or local latv regulafing constructron or the � � � <br /> performance o/constn�ction. That 1��m author�zed by fhe owner o(fhis preperty fo perlomi the ' <br /> work lor which applic<�tion is ntade and 1 comply tvifh the State Contracrors�a�v I827 RCL^/and ��' � <br /> 29G.2D0 WAC. � L ' <br /> ; ; -,1 <br /> _ ' , , 7 <br /> ��� ��1�'� L � '-I - C, <br /> Sigr .,,re Date <br />