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� <br /> 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 /> ���:� � C,�Ks ��,:�= ��r���-:�; <br /> PROJ�CT ADDRESS <br /> .`>;J;'�/�/d��iSl� �:�,;vi y ��-���D J.'GGr:r-i�!'lt,r� n�5H6( Y"t��,�rIT 6��� `��'Oi ��1j SY�f? �yZ�i <br /> Owner L1ail Address City State/Zip Phonc <br /> �JlJc"�C �'IS/� C'uv—� !iV'Cr"/';� sL�,^ kLl��if"�'�w!/,2� NSSL'�j G✓�}C!%T «'/t�/�..'C/ <br /> Tenant h1ai1 Address Cily SlalelZip Phone <br /> U`1��'r_ 'i U �r lk�,.�:- i,J T�c���S�' <br /> Electrical Conlractor hfail Addies� Cily Slale�Zip Phone <br /> �;'OJc� "° <br /> S�ale License Number Coniract Price of Work <br /> 1�i (JN� !�•.STc�:9�✓ <br /> Proposed Use ot Buildinc� Contact Person (Plan Review) <br /> Description o(Work to Be Done: �j/i� 1�1�7.ii 1 1 D, ��F 7Zl�t`t CG4'lGch i ��vS�l�'�,��G- .� ti` w� <br /> ��75 � . �-/� /�.. /'i �/�- 'L!-S <br /> ��7i��- i il'c K�r� [�^.�" ^ ti� �� �ar (., r'�� �,,,�uu c: ria:� Cet� <br /> � . , <br /> yv �NE- "iR iL �c.�S,N�s D�rr��r_ <br /> NOTF: WIRING IN NON-DWELLINGS IS REQUIRED TO F[E <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily that I have read and examined this applicafion and kno�v the same fo be frue and <br /> correcf. All provisions o//a�vs and ordinances c�overnrng fhis type o!�Uvk�vill be completed <br /> �vhether specdied herein or noL The granfin�o/a pernut does nof �Psume to qive authonty to <br /> vio/ate ar cancel fhe provisions ol any other sfate or local la�v reguPting constnicfion or the <br /> � peAomiance o!consVuchon. That I am authorizad by Ihe o�vner o/this property to perfonn the <br /> �vo�k for�vhich application is made and I comply with the State Contractors La�v 1827 RCW and <br /> 296.200 WAC. <br /> Siynature Da;e ,\�1� <br /> .'�`;'}' i' � <br /> ✓ <br />