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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, F_VERETT, WA 98201 / <br /> 425-257-8810 - FAX425-257-8857 –www.everettwa.org �` ��"��b <br /> 1-o�n�-��� <br /> APPL�CATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � <br /> � �/ � � <br /> � � Q,.d� f1�G'� <br /> � <br /> PROJECT ADDRESS <br /> / / i/ y,�s"-��/Y <br /> [�L -?�, l i" � ��L' / ,(!`' � � .'/� — �t,e:r,•r; �fr' 9c''- Cv/y/�' <br /> i <br /> //�/ tC �Or^ /�/r; ��/c'.� Lt <br /> Owner Mail Address City Stale/Zip Phone <br /> � � <br /> ���� <br /> Tenanl A1ail Address Cily Slate/Zip Phone <br /> ��G' � �.S.:�J"_�.�5:�,�TSL✓ CCr v��J�:.+il� !�� /!�. .C/ y PJ�Q'C� <br /> Electri al ConUaclor Mail Address C�y State/Zip Phone <br /> � C, �. �''� `�. %S i� h� �� �. L"Ocv� <br /> State Licensc Num6er Conlrac Price of Work <br /> �'l�cb. t\` � �.lJ> >O�r '��� C� — <br /> Proposed Use o(Di Idin� /J Cantact Person (Plan Review) <br /> / <br /> � . r,��{'� �r�rG r�'. <br /> Descriplion ol Work lo Dc Done: /YLi'�/ �2�-7J-+---�'� d C'�C�; T.�v9 ��N�t//C C. <br /> � � � <br /> ,��w :��� l.� !�;t< <<,_�:�,� s1i�/� � y��9sv� .<l� <br /> ; - <br /> NOTE: WIRING IN NON-DWE�LINGS IS REOUIRED TO FEE <br /> BE IN RACEWAI'S, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 here6y certily fhn(I have read and examined this application and know the same to be t�ue and <br /> conecf. All provisio�u olla�vs anA oidin�nces governmg fhis(ype o(work will be comp/eted <br /> whether speci6ed herein or noL The granting o!a permd does not xesumc fo give aufhonty fo <br /> violate o�cmicel the provisions elany ofher stafe orlocal law regu��(ing consfrucfion or the <br /> performance o/r,onstrucfion. Thaf 1 arn authonzed b}'Ihe o�vner o(flus property fo perlonn the <br /> �vo�k lor�rhich application is made and 1 contply�vifh(he Sta(e Cort�acfe�s Lmv 1t3.2i RCW and <br /> :'9ti200 WAC. ,� --'� � 7 <br /> `i " / � /` � <br /> �' � �J C � '" `��� <br /> i.� / ,/•-G!� 4� ( �� ��-f <br /> � Signalura Date <br /> . (,��`�- <br /> � �y <br /> ` ��C� <br />