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__—_ — _ i <br /> ELECTRICAL PERMIT APPLICATION I <br /> CITY OF EVERETT PERMIT S�RVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX425-257-8857 —www.everettwa.org 3��5—�3 <br /> APPUCATIONS ARE ACCEPTED FROM 8 AM TO 4 PM G�30 '�'��� I <br /> G' <br /> I' I � � �� ,�. , r', �,�' r �����'�i ) 5 z C: r <br /> PROJECT ADDRESS ��I 75� �2 r' <br /> 43Z � � <br /> j r� N I-I�«�S <br /> I �l L i << ���_� R�J� C=��cr� wn � k? �= i � <br /> Owner <br /> MeilAOdress Crty State2tp Phone <br /> Tenant Mail Addresa Cdy StatefZip Phone I <br /> '�j-� � r7 (G�,F�,. �vt= C� i� �.-> j <br /> � � n/1 K►+-ys�,�.��c i,.� A � <br /> J( �I 1 ( ! � �.l,L II�lC <br /> MailAdOress CAy StetelZip Phone <br /> [lectrical Contractor i <br /> I,..:� I '���_ L i_ `�1 � �- I''I�- � ��'�' `-� �I <br /> Siate license Number Conirecl Price oi Work <br /> �L�rz �I r(ZS � Z�7 �-]`ls��( � <br /> y `'C ' r t c L `�� Contad Person (Ptan Review) <br /> Proposed Use ot Building <br /> I � �GO �� � <br /> Square Foolage Qt reside�itiai new construc6on,remodel or addition) <br /> �I Description of Work to Be Done: � ��%� '-r �� �%�"f l�C <br /> II <br /> I NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> il BE IN �ACEWAYS, MC OR AC CABLE. ��� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby ceRify that!have read and examined tbis application and know the same to be true and � � � O 2 _I O(� <br /> ' ccnect. A/l provisions ol laws and ordinances govemmg this typo o/work will 6e completed J <br /> �--helher specdied heiEm or noL The granfing o!a pemut does nof �esume to give authonty fo <br /> violato or cancel the provisions o/any other sfafe orlocal law reguPling consfrucfion or Iho <br /> • pedormance o/consimction. That 1 am authonzed by fhe ownerof fhi�property fo perlonn fhe <br /> i �•ork lor which npplicafioir is made and 1 comply wdh the Sfafe Contracwrs Law 18.27 RCW and <br /> 296.200 WAC. <br /> �� "' � — 7 � ( 5 � 15 <br /> � _ . c -- <br /> I � Signelure Data <br /> j _ � - - - --- -- - - . _ .. . . - - -- <br /> — ----� <br />