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:� <br /> ; <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVlCES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257•8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEP7E0 FROM 8 AM TO 4 PM � �-a 7 ��D <br /> C- 100�--� 3-( <br /> 3.53� �i � ,�= �v` <br /> PROJECT ADDRESS <br /> �j2 `✓,.%,2�---rr LLC_ 35_'��A,,u_ � /3v� �/�,��,r w�o- c Yu�) <br /> Owner Mail Address Ciry SlatelZip Phone <br /> S,�C 1<a�3•,�t%�S :3�3% 1�A,�:rg✓� �vc,?c�r �.I,A- c�ZOI _ <br /> Tenant MailAddress City Slate/Zip Phone <br /> 3�'�v /GE•'Pc, ,uc � ��3 <br /> ,'�MU�L;_;tif�1c.�1N; c%c.GC;, ►wC. �✓c�Z�=,^r GU.+4- ��FZZZ��/t�5/-/t5 <br /> GlectricalConiractor MailAddress City StatelZip Phone <br /> C <br /> S��c�;�",?- �3.3 i�?� " I���� `_ <br /> State License Number Contract Pnce of Work <br /> C�.�r�ec�.u�/i'r fz� ; � — <br /> Proposed Use of Building Contacl Person (Plan Review) <br /> Descnption of Work lo Be Done: r,��,�P /1�(' ie� /1•��7 �t/1�.;! /C��L�,`1 ��t' ( <br /> � � <br /> ►U',� �'U ��s..� ����N.+-�rz��' a��r( ��c�d S'^/ /"�,� - <br /> � ,� <br /> ,. ' � nc�-«'.!: / : � <br /> NOTE: WIRING IN NON•DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily fhaf 1 havo read and examined fhis applica(ion and know the same to Ge We and r �� -� �� <br /> conect All prowsions ol laws and ordinances govemmg fh�s type o(work will be completed �./I <br /> whe(her specilied herein or noG The gran(ing oI a permd does nof resumo(o give aufhority fo <br /> vio/afe or cancel fhe r�rovisions ol any o'her sfafe or local la�v reguPting construclion or the <br /> peAom�ance ol constn�ction. That I am authonzed by fho owner ol fhis property(o peAorm tho <br /> �vork lor�vhich applicalion is made and 1 cornply with(hu Sfa(e Conlracfors La�v 18.27 RCW and <br /> 296200 WAC. <br /> . G�� ���...{/ 7/`�-/�l/ <br /> Signalure Datc <br />