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I __ <br /> ELErTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERYICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX425-257-8857 —www.everettwa.org 5�a�� ,Z <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM C �Z�5'�I a.7 <br /> �l�b /J6i Q"oGt. r6t L 4��c <br /> PROJECTADDRESS <br /> / �2 (�ti �t / � / f�� <br /> Owner MeilAddrese Ciry StelelLp Phona <br /> Tenenl MailAddrese City Slata2ip Phone <br /> ,���/� � v ��e� �yrs �9a��°s�i� ���*��J�� �� .�d�- �iy�ya <br /> Elec rical CoM�actor Mail Addreas Ciry Slete2ip Phona <br /> ,!� „o <br /> /���'�. , o C "� / 7 3 �lP ��.�'c� <br /> Sta e License Number Contracl Price of Work <br /> J— ru/"� �PJ �irrl �OL�- ?/�/—�� <br /> Proposed Use o1 Building Contacl Person (Plan Review) <br /> Square FooL•ige Qf residential new construction, remodel oi addition) <br /> `/ _F/N� ,,( 1 <br /> Description ol Work to Be Done: C�IR�9E� /7r R.f�/' � A �� ���^t° �7P r - <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. -_7 < �L� <br /> ( J <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I here6y certily that 1 heve read end examined Ih'�applicofion ond know the seme fo be true and <br /> conar.t. All provisions ollaws and ordinances goveming fhis type ol work will be complefed c I �'1 !l 5_ I Z �" <br /> whether specr6ed he�ein or not The grenling ol a permd does nof presume fo give aulhonty to l� L�/ <br /> violata or cancel fhe provisions ol eny ofher stafe or local law regulating construchon or the <br /> perfomr�nce o/conslruction. That 1 am autlronied by the owner ol this pmperty fo pe�lorm fhe <br /> work/or which application is made and 1 compty with the Stete Confrecfors Law 18.27 RCW end <br /> 296.200 W.4C.�� ,- � <br /> '��.a � � • ��GI <br /> Signatur Dale <br /> � <br />