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; <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTE�7 FROM 8 AM TO 4 PM -DEBIT S CREDIT CARDS ARE NOT ACCEPTED <br /> � <br /> 9:�lJ �:'��i.�i_�,� � <br /> PROJECT ADDRESS <br /> u�G, .. <br /> /f/i.�/i/1A'f /_,":(�I ��,r:S/� r� �ilf ��7/0"..''� /��.`ii/U��/.��///� /�� / �/-�/ <br /> p�y�a� ' ' Mal!Address Ciry Slate2ip Phone <br /> � <br /> Tep i � y MailAddres� Ciry State2lp Phone <br /> //�_,<,.l r-i�/,-.i���.;�� .Li,r . - <br /> , ' ," _ `r ��///t y'f'�7C/ <br /> �i• v�",i.i,'' .�'�:,7��:.� f%J. Y_:,-' /i 'n� �S� <br /> ElOdfical CoOtraGtof Mail Address Ciry Slate2lp ) Phane <br /> _J �T / ✓ ��� IO.J�.7—f`�i(�:: <br /> ,��,���1�=�y�9�c s , ��o r, <br /> State License Number Contrect Price of Work <br /> �; �� ��,, . /'D���?`��� <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: l//:LO _cS/�� G�/� J�,..�! /�/,G(/� <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 /> !he�eby ceRrly that I have read and examined this application and know the same to 6e frue and <br /> conecf. All provisions of laws and ordinances govemrnQ fhrs type ol wak wip 6e campleted <br /> whetherspecified herein o�not. The grenfing of e permd does notpresume to give authority fo <br /> violafeorcancelthe p/ovisionsofanyothersfateorlocallaw;egula6ngconshuc6'onorfhe <br /> peAormance ol conslrucGon. TAat 1 am authonzed,by lhe ownar of fhisy roperty to perform tha <br /> wor)c lor which applicatron is made and J compiy wrth the S7ate Conhect�rs La:v i8.2'RCW and <br /> 296200 WAC, <br /> y�7� y" � ✓ <br /> �) � Q�.O /Li � /J./.� U .� C�U <br /> S awre Date <br /> ���� <br /> T •d bESBES909E a?�aoaj3 uoc�od dZ; : TO SO ZO 9ny <br />