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ELECTRICAL PERMIT APPLICATION <br /> CITY OF �VERETT PERMlT SERVICES <br /> 3200 CEDAR STREET, EVERETT. WA 98201 � � � �-0 B <br /> 425-257-8810 - FAX425-257-8857—www.everettwa.org �080/—/�7 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM 1 y '' <br /> J '�<• ' f�^++�. <br /> L �G-� <br /> ` Z"� S�'4"�y�! �t�...- <br /> _ ��v� ��r:����_ ���'� �.� .� <br /> PROJECT ADDRESS • <br /> �� �1`I '1�l (" ( ��.{1.!- <br /> � S �i �� / ,� �.l.L.rC-{-� L�.,l { �l �(i�)� 'J ( `�C��`�1� 1 j-�,)t <br /> Owner Mail Addresa Clty StatelZlp Phone <br /> �i �� �-l�C r �a-�i�,k_ _�t�� �tiL.L <br /> Tenant MailAddress City Stale2ip Phone <br /> ( r <br /> �-l��l '�. � � `('._-�l � L�'.�. t"� �I;`�1 (_� �(1 ��{i_1 1<d� E�iYl�Ull 1,-�� 1`i��i � � �IZ`��1�2� (iJi��� <br /> E�eCtrical Contrador Mal Address C� SlalefZip Phone <br /> � 1 l I �i l �>u J'�;�f� �� ��( �1�7• `�� <br /> ., <br /> State License Number Contrad Price of Wort; <br /> C' <br /> � ; il-i ii:'� iV �t�� � ��'-`1-( ,_>'[J�,����-G <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Descnp6on of Wark to Be Done: �-��7�((' 1� � �-�J t;,[. � �('� l�.-� ��l �1'��l C;_.'�, (; �_( �. l lL. <br /> �)l ' +iL�� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. ,� <br /> ���L' • <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 heroby cortily that I have read and examined this application and know the same to be huo and <br /> correct. All provisions o(laws and ordinances govemmg this typo o/wak wi/l be compleled <br /> whefher spocdied heroin or noL Tho granting ol a pormrt does notp resume to give authonty to <br /> violate or cancel tho provisions ol any other sfafe or local law regulatin,q conslmction or the <br /> perlonnanw ol consfrucfion. Thal l am autlionzed by the owner o!fhis property to pedorm the <br /> work for�vhich application is made and 1 compty with tAo Sfate Conlrac(ors Law 18,27 RCW and <br /> 296200 WAC.� . <br /> 1 ' � 1� ry <br /> � (Z: J J - ��� �� O <br /> Signalure Date <br /> �(y t'��I - �� 7 <br />