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ELECTRICAL PERMIT APPLICATION <br /> CtTY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - �AX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ., <br /> � /�;. �!- <br /> PROJECT ADDRESS <br /> `�." <br /> Ownef Mail Addmss Cily Slale/Zip Phone <br /> `/I-�r, 1i7;, /(i l; r; ��CJ/� ��� .�� ✓L� L�v ti� �' V✓w /�S c'O�. <br /> , <br /> Tenanl �tail AJdress Cily Statc/Zip Phone <br /> J-/ Iq C %�p— <br /> I�`' ^ . : , . , ,� ��� ' � , �Jv� �J ��� f..�0i /IiI �JUI y{/�i / d1�J� j�% '�J�UV <br /> Gecirical Conlraclo� Mail AdJress Ciry State/Zip Fhono <br /> '`o, �, , � 7 � ; „ , <br /> i r, ;� �� ; i i � �/c /� -- <br /> Slate License Number Contracl Price of WorM. <br /> . . /' <br /> Proposcd Use of Building CoMacl Person (Plan Review) <br /> Description o(Work to De Done: -" "sf��� �'�� '�e'�'-' �i r'e vf �i.� : . : . 2 <br /> i� �' . . .i/ ;: �li ���SCJn,��! � s oc� � f Ccnr,-� �'7 v 4: t/ <br /> — � p� _ <br /> ' � , i. . � . .. � - � <br /> \ <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RAC[WAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � �__K_ ��. `/� � <br /> I herebvi certil}�fhat 1 have read and eeamined fhis applicalion and kno�v fhe sarne fo be frue and <br /> � V � <br /> correcC All piovisions o/laivs and ordinances gove�nmg fhis f}�pe o(work will6e cornplefed <br /> u�hethc�speci6ed heroin ornnL The yranfing ol a pmmd does nol resume to give au(honty fo <br /> viola(e or cancel the provisions el any other sfafe or local Imv reguPfing consWcfion or fhe <br /> pe�formance ul construchen. Thaf I am authonzed by;he owner o/this prcperty fo pedornt(he <br /> �+�ork/or�rliich application is made and I comply�rifh fhe State Confracfors Lau- 18.27 RCW and <br /> 29&200 lh'AC. 1 <br /> (/' , %l. ����/V/ <br /> Si�nalurc Dale <br />