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� �. D c.t) <br />��. <br />�! <br />owner <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EV�RETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />UI C.. � 1 � i'r <br />� I)ou aa� l�� � �3��Ti , C� �, <br />. 3Ko� 1���9� <br />� <br />�l ��S CLe ��`�� � <br />� hlail Address City Slale/Zip <br />'�ypc i\+�c'�'�x;`'�'.A'� <br />1„��, �V�; t��1ni ��, v �'�''�(-'t�L1 C�2t . Q�i�/ <br />:� <br />3Gr�- ;1�� <br />Phone <br />fG?,S-,?S'9 <br />9zs� <br />Tenant Mail Addmss � � Cily Sta1e/Zip Phone <br />�f7_5 - 3"�-=7,�7 <br />��� �,'.�Ns�, �te��� ,�.yi - ��4• �� ��.R.� s� �.,,� 9�z,-, <br />Eleclrical Conirac�or Mail Address Cily Stale2ip Phone <br />_ T �-�N s � �v � �/ /� (' �'�`s�� �� <br />Slale License Nwnber Contracl Prico of Work <br />'"7 cy C / /� <br />f�i t�t'�I`"iyiJ , C� "'� �Jli�Gl� �I2 L1CG�.iI �' S �e�j _. <br />Proposed Usc af �uilding <br />Uescription o( Work to De �one: <br />c1 d - ; � .3 .— ; r, �� <br />�.a � r'i �) •� <br />NOT[: WIRING IN NON-DWELLINGS IS REQUIR[D TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Conlacl Person (Plan Review) <br />I herehy ceriily fhal 1 have read and examined this npplication and kno�v the same to be t�ue and <br />conecf. All provisiais olla�rs and ordinances governm� fhis lype ol work will be completed <br />�rhefher spea6ed herein or noL The granfing o/ a pemut does not resume fo give aufhonty fo <br />viola(e or cancel the provisions o( mry other sfate or loc��l law reguPfing construction or the <br />perfommnce ol consUucGon. 7hat 1 arn aidho�ized by fhe owner ol this property fo perlonn fhe <br />worA lor which application is made and 1 cornpl}� �rifh Ihe Sfate Confraclois La�v 18.27 RCl1' and <br />296.200 WAC. <br />�c��"'� l� C � � �� (.,r, <br />FEE <br />