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1 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERET"i, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO d PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> ��// ��-� .�� � �✓�-�� <br /> PROJECT ADDRESS <br /> ����'cl� ���e�� /UlDrc.r.� �f�/z �'Z..�UQ//�/� ��9,�l�S✓/cC� �6��5 �" 71 <br /> Ownef Mai ddress City StateRip Phone <br /> /1�c�,��L—� <br /> Tenant Mail Addre�s City State/Zip Phone <br /> d l�il/V�7Z <br /> EledfiC21 COntfaCtOf Mail Address (:ity State/Zip Phone <br /> State License Number Contract Price of Work 3(�Q �`, � �2 v�� <br /> /�c.t-/,�P ��-,-,�� /�o a.�. �-06 5 s!_ 3 k�1� <br /> Proposed Use of Building Contact P son (Plan Review) <br /> Description of Work to Be Done: � ��/��:fc /ii S/� F� �j�4�f ��,,,a � �>�//� <br /> NOTE: �VIRING IN NON-DWELLINGS IS REQUlRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAiC CODE IS 3105 <br /> 1 hereby certify fhat I have read an0 examined this application and know the same to be true and <br /> wrrect. All provisions ollaws and ordinances govemmg this fype o/work will be completed <br /> whether specdied herein or noG The yranting of a peimd does not resume to give aulhonty to <br /> violate or cance/fhe provisions of any other state or local law reguPting construc6on or�he <br />' work/or wh1 ch acor s a6on s ade end I co�m�/Ze�fh(h'e State Conf a�ctor�pLaiv?8 27 Rr W end <br /> 296.200 WAC. PP P y <br /> -�� � �v�s�s� <br /> � ignaNre Date ' ' <br /> �� -�t��j - b I 7 <br />