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n�/,It: 1.. L11,�.� " / <br /> n�.. � ��. � � iJM <br /> �LL�GTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREE7, EVERETT, WA �820'� 2 <br /> 425-257-8810 - FAX 425•257-8857 —www•everettwa.org g ,�g/ � <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM C�'�2D��� <br /> �11�0 � `��'�' ST �E�/ W 1� Q g� I <br /> PROJECT ADDRESS <br /> .�Y`S'.=��1 "�'� �� �� ���� Slale/Zip Phone <br /> OWner Ma�l Addiess CI1y <br /> Tenant M11all Addresa Clty <br /> StatelZip Fhone <br /> S' 1�a�inc, In� 1415 3roU���c�.�� C�e�� ��Pr ��a�o I �I��'"�1 �� <br /> Elactrical Contraclor <br /> h1ailAddress � City State2ip Phone <br /> � p <br /> ��'���d� Q`� CoNract PriCe of WorK <br /> Stata License Number <br /> Proposed Use ot Building Conlact Person (Plan Review) <br /> Description a(Work to Be Done� � S�� / `�`�1 r� � � a� Y n' � ��n S ��� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> B� IN RACEWAYS, MC ORAC CABLE. <br /> '� CITY OF EVERETT LOCAL SALES TAX CO�E IS 3705 <br /> 1 horeby c�dify that 1 Nave roetl antl examined this spplica(ion and know the same to be hue enU �i � 2- �� ' �;, / <br /> correct. All provis�ons of la�vs and ordinonces povomma fhis type ol u�ork will be cornpletod `-�� <br /> �ti�hether spoci�ioU hoiain or not. The c�rontinc�of a permd Joes not p�esuni0 fo]ivo aUthonfy to <br /> violafo a cancol fhe prOvlsions olany ofhorstate orlocallnw roc�ulahng consfrucfion or lhe <br /> podurmanca o/construction. That!am aufhorized Gy fho ownor ol tlris proporty to portorm fho <br /> w,ork lor�vhith applicetion is mado and!cempfy with tho Stafe Contractors La�v 1827 RCW and <br /> 296.200 WAC. <br /> �P,�Ili r� AL7 h.JS $' �' 1�- <br /> �iaf�ature oate <br /> � <br />