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S5e t%'(// cor Ry/Mei7 ¢S <br /> /62 77v — Xc <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 /> 7/c2 LDm&Pd , <br /> PROJECT ADDRESS <br /> 7/,2 .41m&rG1 .4e ever, to4 q i <br /> Owner Mail Address City State/Zip Phone <br /> 4?/A <br /> Tenant Mail Address City State/Zip Phone <br /> /Ylr. j /eek/ l /s c369 ,eve /08s/ r5/eJ/ ZynteitDZ11 ��O3( <br /> Electrical Contractor Mall Address City State/zip Phone <br /> vis 774/" 76100 <br /> mReze-e-c7r9O0C.. _42-40 0-.DO <br /> State License Number Contract Price of Work <br /> X1-14')14 yy-L 97— 6,4'9 <br /> Proposed Usel5f Building Contact Person (Plan Review) <br /> Square Footage(If residential new construction,remodel or addition) <br /> Description of Work to Be Done: /DPCL9 / �jQ. 1221 y re/ce /v Q/how -or- <br /> 4 ?'-) gari8( 112e . (service i/ col-reel/7 oil old gacage), <br /> Q S 1: CD55C°c/ (QQi M! Evere//I ,/25,j 'c/Or- <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE °O <br /> 5-0 <br /> CITY OF EVERETT LOCAL SALES TAX CODE Is 3105 <br /> I hereby certify that I have read and examined this application and know the same to be true and D302,- <br /> O _ <br /> correct. All provisions of laws and ordinances governing this type of work will be completed <br /> whether specified herein or not. The granting of a permit does notresume to give authority to <br /> violate or cancel the provisions of any other state or local law regulating construction or the <br /> performance of construction. That I am authorized by the owner of this property to perform the <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WA <br /> C04 7749-0(2 �/2 61/3 <br /> Signature Date <br />