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— ---- — —� <br /> ELECTRICAL PERMIT APPLIGATION � <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8957 -www.everettwa.org <br /> APPLICATlJNS ARE ACCEPTED FROM B AM TO 4 PM <br /> 7��� 1''X �k���lJ��'� <br /> PROJECT ADDRESS <br /> Owner `._ 5��� �-�•����5%�� Ciry Slate/Zip Phone <br /> Z� '.ti4- yL7L <br /> �P/� �/�%_�f�'Z9 �-y,cl�.�y ����r' �,�1 v� <br /> Tenanl MailAddress � CMy State/Zip Phone <br /> � yz5-35�-�yrY <br /> 1 .(��11< (S v�(j.`(1Gc, I"��ltil cJ��js�a� (�'.�•,-�_(�..!- 9�LZ� <br /> ElectricalCoNractor MailAddress Ciry <br /> � Stale/Zip Phone <br /> � 2��.0� <br /> State License Number Coniract Price oi Work <br /> /�r �',� /�,:c /l�� <br /> Proposed Use of Buildin Conlact Person (Plan Review) <br /> Square Foolage(If residential new conslruclion, remodel or addition) <br /> Descriplion ot Work to Be Done: V/C���� r""� P � �/ <br /> � <br /> NOTE: WIRING IN NON-D1�LLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE, <br /> 117 • `� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hera6y certi(y that 1 havo mad and examined this application ar�d kno�v(I�e sarne to 6e fn�e and r1 I <br /> carect. All provisions of laws and ordinances goveming flus type o(�vork�rill be completed � I �V � <br /> whether specdied hemin or noL The granting ol a pennd does not presmne to give au(honty(o <br /> violafe orcancel fhe Provisions o(any o(herstate orlocallaw regulating cons6uc6on or fhe <br /> peilormance o/consfiuction. That 1 am authonzed 6y fhe o�vner o!this propeiiy to pe�fomi fhe <br /> �+�oik!or which application is mado and J comply wifh the Stafe Con(ractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ���� <br /> �� ���L <br /> 'Si e Date � <br />