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, <br />�- �S-�_� �_; <br />_ -- -- ---- <br />'; <br />ELECTRICAL PERMIT APPLICATION <br />' CITY OF EVERETT PERMIT SERVICES <br />i 3200 CE-UAR STRFET, EVERE?T, WA 9E201 <br />d25-257-8810 - FA;t �325-257-9857 — �w.tiv.everetT,ve.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 1 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />�, 1 ( ) <br />, I " � \ i �L �JI p J- (_ 1 i ( ` � II'`) �I I J � <br />PROJFCT ADDRESS <br />Owner <br />r�t�r, l�':��, �/�� <br />htail Address Cily State2ip Phone <br />� j1�� � i1 IJ, >� :� t J� � ��.,� i', (.�( C�A '/��� <br />Tonant �� Mail Address City State'Zip Phone <br />( �/ i ) I �It,(� 2_Z`�i_ <br />%� �.C!• r/CC�ti��[- 1L.� j � �U��l��ol/l.�C, �L�v1t��n.��°� ��i�S� �E.+%��� <br />[leclrical Conlrac;or Mdil AAOress Ciry Stale!Zip P�one <br />M�L ; i� i� L v �5 D�i <br />State License Number <br />Praposed Usc nf Building <br />Contract Prico of Work <br />Contacl Person (Plan Review) <br />Desciiption ot Work to Be Done: ( 1 � �� r��C , � � `i �- l� p��� F� �� �.. f l.�, � r' �• -� �r. .r,l �1 S <br />(� ���C f-�Ct-� �� J'✓�•i�... � � �-i-�'� l� /�� C' �C i�� �"f C.�i L�—� X-t-L.ly' PS � Yv �i1nvS�' <br />i <br />��iU ��i� <br />NOTE: WIRING IN NON•DWELLINGS IS RE4UIREG TO <br />BE IN RACEVVAYS, MC Ok AC CABLE. <br />CI7Y OF EVERETT LOCAL SALES TA7( CODE IS 3105 <br />'�ierebvi cernly ;hnf l ho�,e read antl axamrneu ,his aoobca6on and knc�vlhe same to be true and <br />�,rrecL All Prov;sions ol lairos and ardmanCes y,�v�r„iny fhis type JI worN will be complefed <br />.ineflier speo6eU nrre�n or nct. r`he gianting o! a permrf dees ncf presume fo grve authonty t� <br />.,cJate or �ancel the prewsions ol any �fher sfate or iccaf I:;w reguloGng sonstructicn or (he <br />rmrtormance o� construcho{r. ihal 1 am aufhonzed by Ihe own=r ol th�s property to peAorm the <br />�,vr�k 7or whicn apphcoLo�s rr,a� and I comply wrth fhe Sfate Ca�fracicrs Law ?H.2r RCW antl <br />:.'9G.200 WAC. <br />!� ' � _ — - <br />�C / ,i`_. —� j . ��•1C'c;`� <br />,^-.._ <br />FEE <br />