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� � <br /> ELECTRICA� PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAk STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257•8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTE� FROM 8 AM TO 4 PM <br /> �C'�3S �`"I��, o,✓e 5� �,�.-.�� l.��. cl �.�� 1 <br /> r <br /> PROJECT ADDRESS <br /> (.!.r„ �S l.�11 ,�U�� (�.����1 li f 5�..1 �V'c��`I I 2.,/r � cj6�J�� ���5"p7b 75� � <br /> Owne Mail Address City State2ip Phone <br /> � �� F <br /> Tenant Mail Address Ciry State/Zip Phone <br /> ��s--�r <br /> Electrical ConVactor Mail Adtlress Ciry State/Zip Phone <br /> State License Number Contract Prce of Work <br /> S�On ���IC�L� <br /> Propased Use of Building Contact Person (Plan Review) <br /> Description af Work lo Be Done: G}c��c�.�. l lJ�t� /�n � �U,; � ,� �1�.. <br /> � — <br /> NOTE WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. i, , <br /> /h-�) — <br /> � J C� <br /> CIN OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I here6y certily thaf 1 have 2ad and examined this application and know the same fo be hue and <br /> correcf. All provisions ol laws and oNinances goveming this type of work will be completed <br /> whether specil�ed herein or not. The granting ol a permd does nof piesume to give authority to <br /> viofata or cancel the provisions o(any other sta/e or local law regu/a�ing cronstiudion or the <br /> peAormance of construcfion. That I am aufhonzed by the owner of this property to peAorm the <br /> work/or which app/ication is made and I comply with the Stafe Contradors Caw 18.27 RCW and <br /> 296.200 WAC. <br /> /� .�'��� �- � - D � <br /> �Synat�el Date /� <br /> _ / (L�l�i� <br />