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( � _ <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY AF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—wvuw.everettwa.org —7�(3 ...r Z <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM L�Zv')—('7J�5 <br /> 7 ��� -�- ve..�J/PPn �✓�I <br /> PROJECT ADDRESS <br /> Q.� /D/�6 A/E �� ���v��� l✓.q. � <br /> Owner MallAddress City StatelZip Phona <br /> Tenant Mail Adtlress City StatelZip Phane <br /> .,o <</< < <e�,���S F�°d,•,�,r�� ��,�w,/, �,�/.� q�/Td <br /> EI ctrical Contrector � Mail Address City Slate2lp �� —��hO3,� <br /> ��a� �Sr1Gl.�D iPG�`� <br /> State License Number Contract Price of Werk <br /> Proposed Use of Building Contact Person (Pian Review) <br /> Square Foolaga(If residenlial new construction,remodel or addition) <br /> Description of Work to Be Done: � 5/7�� ���/� v, C� " '~�"- <br /> CP �a✓P �'q va� S�r�S <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. �O�j <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 — <br /> 1 hereby certifv fhat 1 have read and examined fhis applicafion and know Ihe same to be frue and �I 1 �� � <br /> correct. All piovisions o/laws and ordinances goveming Ihis lype o/work will be completed GQ � <br /> whefher speci(ed he2in or not. The granting ol a pemuf does not presume to give authority to <br /> violate or cancel the provisions o/any olher sfate or local law regulafing construr,tion or the <br /> peAormance o/conslrucfion. Thaf I am authorized.by Ihe owner o/this propeAy to perform the <br /> work for which applicafion is made and 1 comply with Ihe State Contracfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> /��_ ,>�/r <br /> �SignaWre a��e <br />