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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 96201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> 10 —2-a--12 <br /> APPLICATIONS ARE ACCEPTED PROM 8 AM TO 4 PM � 17�p _��-3 <br /> � �C7"7 �O�l�� f-f-�� � c? � �i' 7t T� C n IL <br /> PROJECT ADDRESS <br /> Owner Mail Address �M $1a1�'P PhO�e <br /> hr—u7 LN'K CJ- /`� / CL�� � ,.1 5�f'�J TiiPrP� t4L�, /,� o�Q� <br /> Tenent Mail Pddres� Ciry StatelLp Phone <br /> � ��� 1 ✓ 7-��, c , G_�'� I I �' �<' y7Z, Su,���.5'a l/_c�t w� 9�'��L .zS3���G� �c� <br /> � Phone <br /> Electncal Conlractof Mail Address Ciy � SlatelLp <br /> 1 F � c,� -�- ( � S'J� �S—�-o <br /> State License Number Contrad Pdce of Work <br /> C� �-�i � L ?��` ��`"—` - <br /> Proposed Use o(Building Contact Person (Plan Review) <br /> 'J..,r. . • �-./ <br /> Square Foolage pf residenlial new construdion,remodel or addition) <br /> x?c�tnt�./ � � �t�.-v v0(-( � <br /> �escnption of Work to Be Done: l� � d-tL i t��A r �s.r-lS �i �' � �� �' <br /> •NOTE: WIRING IN iN-DWELIINGS IS REQUIRED TO FEE ��l <br /> BE IN RAC '.AYS, MC OR AC CABL[. �r�Gv <br /> l/ <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> 1 hereby certdy thr,t 1 have read and examined lhis app/ication and know Ihe sane to be true and �I '` � <br /> correcL All p�owsions ol lews and ordinances govemmg fhis type ol work will be completed Z� �1— 3 <br /> whether specdied herein or nof. The granfmg o/a pemuf does not resume to grve aufhonty to <br /> violate or cancel ihe prov�:ions o/any ofher stafe or local law reguPaling constniction or the <br /> periormance ol conslrucl�on. Thaf 1 am authonied 6y ihe owner o/this property to peifo�m fhe <br /> worh lor which application Is made and!compty wilh tho State Contracfors Law 1827 RCW and <br /> 296 200 WAC. <br /> �� /0 �-2 'Z I <br /> Sign�lure / Date <br />