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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> _ "L 3�G !`'7,�� � f I C��..��C I�, ,l.c�/9 � <br /> PROJECT ADDRESS ��` �I � � C� �ZO 3 <br /> ���L>5 /�0�-4-�1�,1�-��+ I.�f..L �j� � � �Bf�i ��� s�� �., � 3�o r,}a��z✓��e tJ�� 9�'c�1S(y�.5 �7��c3- <br /> Owner Mail Address Ci1y Stale/Zip Phone <br /> J�I A <br /> Tenant hlailAddress City State2ip Phone <br /> i[iC. V-.� r� Iti � XCv.��V���J�nY��L.S x'r�Gi W� ��C�I�U (7L�1! 57 �J�`/ <br /> Eleclrica�Coniractor MailAddress City Stale/Zip Phone <br /> �i���Z � 5`3 73 i�cJ ��• ��co <br /> Slate License Number CoNra t Pnce o(Work <br /> ��� w:rC,��i ( �''t^ �2�-� l.-...�.��ic.�� �Zdb� S/ �'-i 7 7 <br /> Proposed Use of Bwlding Contacl Person (Plan Review) <br /> Description of Work to Be Done: 1' � �Z- f� t �✓� �j 5� �C� v� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. � / 7 5 �� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 9105 n /1 <br /> 1 heieby ceriily fhat 1 have read and eza�r�ined Ihis application and know Ihe same fo bo frue and ��� C��v�� <br /> conact. All provisions ollmvs and ordinances gm�ernrng this type ol wark�vill be completed <br /> whefher speci(ed herem o�noL The granting of a perrnd does no(presume to give aulhonty to <br /> violafe or cancel the�rovisions ol any other sfale or local law regulafmg consfnichon or fhe <br /> perfom�ance o/cons n�clion. Thaf 1 arn aufho�izeJ by fhe owner o/Ihis property fo pedomi Ihe <br /> �voik lor�vhich applicafion is made and I compty wdh fhe S,'afe Confraclors La�v 78.27 RCW and <br /> 296.200 WAC. _ <br /> j� ; � // �� <br /> ! l / / � , ; ..-�-u /Z/��;/��� <br /> i <br /> % Sig�a4'ye Dale <br /> / <br />